急性淋巴细胞白血病患儿出现水痘并发症的危险因素分析

Analysis of risk factors of varicella complications in children with childhood acute lymphoblastic leukemia

目的分析急性淋巴细胞白血病(ALL)患儿出现水痘并发症的危险因素。方法回顾性分析2012年1月至2020年12月苏州市第五人民医院收治的31例ALL合并水痘患儿的临床资料,采用单因素分析及二元Logistic回归分析儿童ALL患儿出现水痘并发症的危险因素。结果31例ALL合并水痘患儿中出现并发症20例,以肝功能异常最为常见。出现并发症患儿存在粒细胞缺乏症占比及谷丙转氨酶、谷草转氨酶、γ-谷氨酰转肽酶水平均高于未出现并发症患儿,白细胞计数及肌酐水平均低于未出现并发症患儿,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,低水平肌酐为ALL合并水痘患儿出现并发症的独立危险因素(OR>1,P<0.05)。结论对于ALL合并水痘患儿,出现水痘并发症是预后不良的重要信号,发病早期通过监测相关临床特点,可预测并发症的发生,及时进行相关干预,可改善预后及降低病死率。

Objective To explore the risk factors of varicella complications in children with acute lymphoblastic leukemia(ALL).Methods The clinical data of 31 children with ALL complicated with varicella treated in Suzhou Fifth People's Hospital from January 2012 to December 2020 were retrospectively analyzed,the risk factors of varicella complications in children with ALL were analyzed by single factor analysis and binary Logistic regression analysis.Results Among the 31 children with ALL complicated with varicella,20 had complications,and abnormal liver function was the most common complication.The proportion of agranulopenia and the levels of alanine aminotransferase,glutamic oxalacetic aminotransferase andγ-glutamyl transpeptide in children with complications were higher than those in children without complications,and the levels of leukocytes and creatinine were lower than those in children without complications,and the differences were statistically significant(P<0.05).The results of binary Logistic regression analysis showed that low creatinine was an independent risk factor for complications in children with ALL complicated with varicella(OR>1,P<0.05).Conclusion For children with ALL complicated with varicella,the occurrence of varicella complications is an important signal of poor prognosis,the occurrence of complications can be predicted by monitoring relevant clinical characteristics in the early stage of onset and timely intervention can improve the prognosis and reduce mortality.