恶性血液病合并粒细胞缺乏患者并发深部真菌感染的研究

目的：研究恶性血液病合并粒细胞缺乏患者并发深部真菌感染的临床特点。方法：回顾性分析30例粒细胞缺乏合并DFI患者的资料。结果：接受骨髓移植、多次化疗、反复应用激素及免疫抑制剂等治疗的粒细胞缺乏患者,细胞及体液免疫功能明显降低,同时长期应用广谱抗生素破坏了宿主正常菌群生态平衡,成为真菌感染的高危人群。医院内DFI的病原菌主要为白色念珠菌,占61.8%;应用rhG-CSF等药物能缩短粒缺的时间,有利于DFI的治疗。结论：粒细胞缺乏的血液病患者极易并发深部真菌感染,应尽早行保护性隔离。应及时应用rhG-CSF,缩短白细胞减少持续时间,合理使用抗生素,对高度怀疑真菌感染病灶存在时应预防性应用抗真菌治疗,适时据培养结果选用有效抗菌药物。

Malignant hematologic diseases complicated with deep fungal infection

Objective：To study clinical features of malignant hematopathy complicated with agranulocytosis associated with deep fungal infection.Methods： Retrospective analyze the data of 30 case combined with DFI.Results： Bone marrow transplant,repeated application of multiple chemotherapy hormone and immunosuppressive agents such as treatment with neutropenia,cellular and low humoral immunity in,long-term broad-spectrum antibiotics were high risk factors.DFI pathogens in hospitals was mainly Candida albicans,61.8%.Conclusion： Neutropenia of deep fungal infection in patients with hematological disease,should have protective isolation;rhG-CSF application, shortening the duration of leukopenia,rational use of antibiotics are useful for patients.