多发性骨髓瘤患者合并感染的危险因素分析与控制

Risk Factors and Control of Multiple Myeloma Complicated with Infection

目的分析多发性骨髓瘤(MM)患者感染相关危险因素,探讨降低感染发生率的措施。方法收集2016年11月至2018年8月郑州大学人民医院收治的251例MM患者的临床资料,其中感染组118例,未感染组133例。通过χ2检验和多因素Logistic回归分析感染的危险因素。结果多因素Logistic回归分析显示体力活动状态(PS)评分高、化疗次数多、低白蛋白水平、低血红蛋白水平、低中性粒细胞水平、高β2微球蛋白水平是MM患者发生感染的独立危险因素(均P<0.05)。结论体力活动状态差、化疗周期多、低蛋白血症、贫血、中性粒细胞减少、β2微球蛋白水平高是MM患者合并感染的危险因素。加强护理工作、预防性应用抗病毒/抗菌药物、加强营养等有助于降低MM患者感染发生风险。

Objective To find the risk factors of infection in patients with multiple myeloma(MM),and to explore measures to reduce the risk of infection.Methods The clinical data of 251 MM patients admitted to People’s Hospital of Zhengzhou University from November 2016 to August 2018 were collected,of which 118 were infected and 133 were uninfected.The risk factors of infection were analyzed byχ2 test and multivariate Logistic regression.Results Multivariate Logistic regression analysis showed that high performance status(PS)scores,too many times of chemotherapy,low albumin level,low hemoglobin level,low neutrophil level,and highβ2 microglobulin level were independent risk factors of infection in MM patients(all P<0.05).Conclusion Poor physical activity status,multiple chemotherapy cycles,hypoproteinemia,anemia,neutropenia,and high level ofβ2 microglobulin are risk factors for infection in MM patients.Enhanced care,preventive use of antiviral/antimicrobial drugs,and enhanced nutrition could help reduce the risk of infection in MM patients.