摘要
目的:分析并探讨造成恶性肿瘤患者合并侵袭性念珠菌感染的原因,为改善其预后提供理论依据。方法:回顾性分析2013年12月至2015年12月天津医科大学肿瘤医院发生的侵袭性念珠菌感染的恶性肿瘤患者临床资料,采用Fisher's精确概率法对预后相关因素进行分析,应用Logistic回归分析造成不良预后的独立危险因素。结果:共125例恶性肿瘤患者合并侵袭性念珠菌感染,主要病原菌为白色念珠菌(42.4%),非白色念珠菌中主要为光滑念珠菌(21.6%),近平滑念珠菌(16.8%)及热带念珠菌(10.4%),主要感染部位为腹腔(51.2%);侵袭性念珠菌感染归因病死率为26.4%,氮质血症、体腔置管(≥2根)、抗真菌治疗的延迟及合并细菌性感染是预后不良的独立危险因素,而首次念珠菌培养阳性前30 d内手术则是保护因素。结论:恶性肿瘤患者合并侵袭性念珠菌感染病死率较高,在临床工作中应对相应危险因素积极干预,并及时开展抗真菌治疗,改善预后。
Objective：To evaluate the predictors for the mortality of patients with malignant tumor and invasive candidiasis in order to contribute to the strategies of prognosis improvement.Methods：This retrospective study includes patients with malignant tumor and invasive candidiasis who were hospitalized during 2013 to 2015.Their clinical characteristics,medication treatment,types of tumor,and mortality rate were collected and analyzed.Categorical data were analyzed by the Fisher＇s exact test.Factors with a P value 0.05 were included in the multivariate Logistic regression model to determine the independent risk factors.Results：A total of 125 patients with malignant tumor with invasive candidiasis were included.The major pathogen was still Candida albicans,which caused 42.4% of the infections,followed by Candida glabrate（21.6%）,Candida parapsilosis（16.8%）,and Candida tropicalis（10.4%）.Abdominal candidiasis（51.2%） was the most common type of infection.The crude mortality rate for invasive candidiasis was 26.4%.Azotemia,more than two indwelling catheters,delayed antifungal treatment,and combination with bacterial infections were the independent risk factors for the death of patients with malignant tumor and invasive candidiasis as compared with the survival group.Surgery within 30 days before diagnosing candidiasis was confirmed to be a protective factor for prognosis.Conclusion：Invasive candidiasis among patients with malignant tumor induced a high mortality rate.The data on the predictors for death may be valuable in developing strategies for prognosis improvement.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2017年第22期1130-1134,共5页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金项目(编号:81302250,81372307)
天津医科大学基金项目(编号:2016KYZQ03)资助~~
关键词
念珠菌
侵袭性感染
恶性肿瘤
预后
危险因素
Candida, invasive infections, malignant tumor, prognosis, risk factors
