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目的探讨血液肿瘤患者侵袭性真菌感染(IFI)的流行病学特征。方法回顾性分析静脉化疗(A组,235例)和造血干细胞移植(B组,41例)血液肿瘤患者IFI发病率,随访患者治疗及预后,分析影响IFI发病的危险因素。结果两组各有4例发生IFI;B组IFI发病率高于A组(9.8%vs.1.7%)(P<0.01)。随访期间,A组4例IFI患者均治愈,B组3例IFI治愈,1例好转。B组5例死亡,死因均与IFI无关。IFI发病的危险因素包括深静脉置管、粒细胞缺乏、持续性发热、联合应用2种及以上广谱抗生素超过7d、病毒感染、低蛋白血症、入院时ECOG评分≥2分(P<0.05)。结论需要重视血液肿瘤患者IFI的危险因素,及早诊断,并采用抗真菌药物治疗。
Objective To investigate the epidemiological characteristics of invasive fungal infection (IFI) in hematological malignancies. Methods The incidence of IFI in patients with hematologic malignancies undergoing intravenous chemotherapy (group A, n = 235) and hematopoietic stem cell transplantation (group B, n = 41) was retrospectively analyzed. The follow - up of patients was followed up and prognosis. Results IFI was observed in 4 of the two groups. The incidence of IFI in group B was higher than that in group A (9.8% vs.1.7%, P <0.01). During follow-up, 4 IFI patients were cured in group A, 3 IFI patients in group B were cured, and 1 patient improved. B group 5 deaths, the cause of death has nothing to do with IFI. Risk factors for IFI included deep vein catheterization, agranulocytosis, persistent fever, combined use of two or more broad-spectrum antibiotics for more than 7 days, viral infection, hypoalbuminemia, ECOG score ≥2 points on admission (P <0.05 ). Conclusion It is necessary to pay attention to the risk factors of IFI in patients with hematologic malignancies, to diagnose them as soon as possible and to use antifungal drugs.