儿童急性白血病死亡原因及危险因素探索

目的:探讨儿童急性白血病患者的死亡原因及危险因素。方法:对河南省肿瘤医院2007年7月至2010年7月期间收治的53例儿童急性白血病病例、17例在院死亡病例进行回顾性分析,并应用Logistic回归单因素与多因素分析,对死亡病例危险因素进行探索。结果:17例死亡病例中,死亡原因主要是感染,其次是出血。高白细胞血症、高血清LDH水平和婴幼儿白血病患者治疗效果不佳,是急性白血病患儿死亡危险因素(P<0.1)。结论:初诊时年龄、外周血白细胞计数和血清LDH水平是儿童急性白血病患者死亡危险因素。防治感染并及时纠正治疗早期出血倾向可有效降低化疗相关死亡率。

Study on the dead reasons and risk factors of acute leukemia in children

Objective: To explore the dead reasons and risk factors of acute leukemia(AL) in children. Methods: The clinical data of 53 cases of children with AL and 17 dead cases who were admitted to Henan Tumor Hospital from July 2007 to July 2010 were reviewed.Logistic Regression was used to analyze the risk factors. Results: In the 17 dead cases,the main cause of treatment-related mortality(TRM) was infection,then bleeding.The curative effects were not good in the children with hyperleukocytosis,high serum LDH level and acute leukemia in infant,which were the risk factors(P<0.1). Conclusion: The age,WBC counts and serum LDH level in first clinics are the risk factors of children with AL.Treatment of infection and more emphasizes puted on bleeding during early treatment in children with AL can reduce TRM.