摘要
目的探讨初治多发性骨髓瘤(MM)老年患者化疗后感染的临床特点、易感因素及对预后的影响,以降低感染率。方法对2000年2月-2013年3月85例初治老年MM患者化疗后感染的临床资料进行回顾性分析,所有数据采用SPSS 13.0软件进行统计分析。结果患者化疗后感染45例,感染率为52.9%;64.4%的感染发生于第一个疗程后,PD方案与传统化疗方案相比感染率差异无统计学意义;感染部位以呼吸道感染最多见;36例患者检出病原菌52株,其中革兰阴性杆菌占44.2%、革兰阳性球菌占19.2%、真菌占36.6%;肾功能不全、低白蛋白血症、粒细胞减少、ECOG评分≥3分为感染的易感因素。结论老年多发性骨髓瘤患者是化疗后感染的高危人群,感染后生存期短、早期病死率高,化疗期间需加强免疫保护。
OBJECTIVE To explore the clinical characteristics of infections in the elderly patients with multiple mye‐loma （MM） after chemotherapy ,analyze the predisposing factors ,and observe the influence on prognosis so as to reduce the infection rate .METHODS The clinical data of 85 elderly patients with MM who received the initial treat‐ment from Feb 2000 to Mar 2013 and were complicated with infections after chemotherapy were retrospectively an‐alyzed so as to provide guidance for prevention of the infections .RESULTS A total of 45 patients had the infections after chemotherapy with the infection rate of 52 .9% ,of whom 64 .4% had the infections after the first course of chemotherapy ;there was no significant difference in the infection rate between the PD regimen and the convention‐al chemotherapy regimen .The respiratory tract infection was the most common .Totally 52 strains of pathogens were isolated from 36 patients ,of which 44 .2% were gram‐negative bacilli ,19 .2% were gram‐positive cocci ,and 36 .6% were fungi .The predisposing factors for the infections included the renal dysfunction ,hypoalbuminemia , neutropenia ,and ECOG score no less than 3 points .CONCLUSION The elderly patients with MM are the popula‐tion at high risk of the infections after chemotherapy ,and the infections lead to shortening the survival period and increase of early mortality ,thus ,it is necessary to strengthen the immunoprotection during chemotherapy .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第22期5186-5188,共3页
Chinese Journal of Nosocomiology
基金
北京市医院管理局临床医学发展基金资助项目(XMLX201502)
关键词
老年患者
多发性骨髓瘤
化疗
感染
Elderly patient
Multiple myeloma
Chemotherapy
Infection
