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目的探讨急性白血病患者医院感染热带假丝酵母菌性败血症的临床特点及危险因素。方法回顾分析1997年1月~2008年12月收治的经血培养证实27例急性白血病合并假丝酵母菌性败血症中23例热带假丝酵母菌性败血症的临床资料。结果27例急性白血病合并假丝酵母菌属性败血症,热带假丝酵母菌23例(85.2%),23例患者均有高热(100.0%),伴寒颤7例(30.4%),皮疹7例(30.4%),合并感染性休克5例(21.7%),肺部病变16例(69.6%),肺多发结节7例(30.4%),肝脾多发结节4例(17.4%),抗真菌治疗总有效率60.9%,两性霉素B、卡泊芬净有效率分别为71.4%与75.0%,感染相关死亡9例,死亡率为39.1%。结论急性白血病医院感染假丝酵母菌性败血症中热带假丝酵母菌是主要菌种,治疗首选两性霉素B、卡泊芬净。
Objective To investigate the clinical characteristics and risk factors of hospital-acquired candidal septicemia in patients with acute leukemia. Methods The clinical data of 23 cases of Candida tropicalis in 27 cases of acute leukemia complicated with Candida septicemia confirmed by menstrual blood culture from January 1997 to December 2008 were retrospectively analyzed. Results Twenty-seven cases of acute leukemia with Candida septicemia, 23 cases of Candida tropicalis (85.2%), 23 patients with hyperthermia (100.0%), 7 cases with chills (30.4%), 7 cases with rash %), Septic shock in 5 cases (21.7%), lung disease in 16 cases (69.6%), multiple pulmonary nodules in 7 cases (30.4%), multiple hepatic and splenic nodules in 4 cases (17.4%), antifungal therapy The total effective rate was 60.9%. The effective rates of amphotericin B and caspofungin were 71.4% and 75.0%, respectively. The infection-related deaths were 9 and the mortality rate was 39.1%. Conclusions Candida tropicalis is the main strain of Candida septicemia in hospital-acquired acute leukemia. The treatment of choice is amphotericin B and caspofungin.