摘要
目的了解造血干细胞移植(HSCT)后患者侵袭性真菌感染(IFI)的发病率及危险因素。方法选择2003年6月至2004年9月于我所进行 HSCT 的患者148例,按照我国 IFI 的诊断标准及临床疗效进行回顾性分析。结果诊断 IFI 的患者共52例,其中确诊者35例,拟诊者17例。其发生时间为移植后2～400d,中位时间为62d。确诊 IFI 在移植后3、6个月及1年的累积发病率分别为15.6%、42.5%、48.9%。根据多因素分析,早期 IFI 的危险因素为:Ⅲ～Ⅳ度的急性移植物抗宿主病(GVHD)、广谱抗生素的长期应用及巨细胞病毒感染;晚期 IFI 的危险因素为:广泛型慢性 GVHD和激素的长期应用。结论具有较多危险因素的 HSCT 受者更易发生 IFI,而避免或减少上述危险因素是预防 IFI 的有效方法。
Objective To study the incidence and risk factors of invasive fungal infection（IFI） in allogeneic hematopoietic stem cell transplant （HSCT） recipients. Methods One hundred and forty-eight patients, undergoing formed HSCT at this institute from June 2003 to September 2004, were analyzed retrospectively according to the diagnostic criteria of IFI. Results Fifty-two cases of IFI were diagnosed, with 35 proven and 17 probable. The infection occurred a median of 62 days after HSCT and the cumulative incidence of proven IFI in 3 months, 6 months and one year after HSCT were 15. 6%, 42. 5% and 48. 9% respectively. By multivariate analysis, the variable associated with early infection risk were severe acute graft-versus-host disease （GVHD）, prolonged administration of broad spectrum antibiotics and cytomegalovirus infection, while chronic extensive GVHD and glucocorticosteroid use were associated with the late-onset IFI. Conclusion Patients undergoing HSCT and having many risk factors are more likely predisposed to IFI, avoiding the risk factors might could reduce the incidence rate of IFI.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2007年第6期486-489,共4页
Chinese Journal of Internal Medicine
关键词
造血干细胞移植
侵袭性真菌感染
危险因素
Hematopoietic stem cell transplantation
Invasive fungal infection
Risk factor
作者简介
通信作者：黄晓军，Email：xjhrm@medmail．com．cn
