本文選題：侵襲性 + 真菌��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年05期

【摘要】：目的探討惡性血液病侵襲性真菌感染(IFI)的影響因素及真菌感染前后腸道菌群結(jié)構(gòu)的變化情況,為惡性血液病侵襲性真菌感染的診治提供依據(jù)。方法選擇醫(yī)院2010年1月-2015年12月血液科惡性血液病患者1000例,將其中164例IFI患者作為觀察組,另選取164例健康者為對照組,采用單因素及多因素logistic分析IFI的影響因素及PCR法檢測腸道菌群情況。結(jié)果急性白血病和骨髓增生異常綜合征、有基礎(chǔ)疾病、應(yīng)用糖皮質(zhì)激素、抗菌藥物應(yīng)用時間7d、抗菌藥物種類2種、白細(xì)胞計數(shù)≤1.0×109/L者IFI的發(fā)生率高于淋巴瘤+慢性白血病+多發(fā)性骨髓瘤、無基礎(chǔ)疾病、未應(yīng)用糖皮質(zhì)激素、抗菌藥物應(yīng)用時間≤7d、抗菌藥物種類≤2種、白細(xì)胞計數(shù)1.0×109/L者(P0.05);應(yīng)用糖皮質(zhì)激素、抗菌藥物種類2種、白細(xì)胞計數(shù)≤1.0×109/L是IFI的獨立危險因素(P0.05);惡性血液病IFI感染時外周血淋巴細(xì)胞、白細(xì)胞、中性粒細(xì)胞水平(1.13±0.67、7.46±2.14、0.27±0.03)×109/L均明顯低于感染前(9.02±1.04、38.24±11.43、3.52±0.86)×109/L(P0.05);觀察組感染前和感染時腸道真菌量明顯高于對照組(P0.05),觀察組感染前和感染時細(xì)菌量明顯低于對照組(P0.05);觀察組感染時真菌量高于感染前(P0.05),觀察組感染時細(xì)菌量低于感染前(P0.05)。結(jié)論應(yīng)用糖皮質(zhì)激素、抗菌藥物種類2種、白細(xì)胞計數(shù)≤1.0×109/L是惡性血液病侵襲性真菌感染的獨立危險因素,惡性血液病侵襲性真菌感染和腸道真菌量增加、細(xì)菌量減少有關(guān)。
[Abstract]:Objective to investigate the influencing factors of invasive fungal infection (IFI) in malignant hematopathy and the changes of intestinal flora before and after fungal infection in order to provide evidence for the diagnosis and treatment of invasive fungal infection in malignant hematopathy. Methods 1000 patients with hematologic malignancies were selected from January 2010 to December 2015 in our hospital. 164 patients with IFI were selected as the observation group and the other 1000 healthy persons as the control group. Single factor and multivariate logistic were used to analyze the influencing factors of IFI and PCR method was used to detect intestinal flora. Results Acute leukemia and myelodysplastic syndrome had basic diseases. Glucocorticoids and antibiotics were used for 7 days. The incidence of IFI in patients with leukocyte count 鈮，

本文編號：1884019