急性白血病合并感染的临床观察

目的探讨急性白血病患者发生情况及相关因素。方法回顾分析50例患者并发感染的患病率、影响因素,细菌谱及在常规抗感染治疗基础上并用粒细胞集落刺激因子（G-CSF）对疗效的影响。结果 AI患者并发感染的患病率为94.3%,革兰阴性（G-）杆菌占42.4%,革兰阳性（G＋）球菌占49.2%,真菌占8.4%;血培养G杆菌以大肠埃希苗及铜绿假单胞菌为主,感染主要与患者中性粒细胞绝对值（N）降低有关;AL患者并发感染总病死率为6%,发生肺部感染及败血症的患者病死率增高,而使用G-CSF的病死率较低。结论 AL患者是并发感染的高危人群,影响因素主要是N减少,在合理使用抗生素治疗的基础上加用C-CSF有助于提高抗感染的疗效。

Clinical Observation of Acute Leukemia Complicated Infection

Objective To study the clinical features of acute 1eukemia（AI.） patients with complication of infection.Methods A retrospective analysis of prevalence of infection occurring in 123 AL patients,their bacterial spectrum,and the effect of C-CSF on the infection were done.Results The prevalence of infection inAI patients was 94.3%,among which 49.2% were infected with Gram positive organisms,42.4% with Gram negative bacilli and 8.4% with fungi.Blood culture occurred mostly with Escherichia coli and Pseudomonas infection.Patient 7s neutropenia was significantly related to the infection.The patients with neutrophil count less than 0.2×109/L had more frequently suffered severe infection with long-lasting time,and had more than two sites of infecfion.Age.hemoglobin level,prophylactic intestinal usage of antibiotics could not reduce patient’s infection.The total mortality of AL patients with infection was 6%.Pulmonary infection and septicemia increased mortality.But G-CSF therapy reduced it.Conclusions AL patients are at high risk of infection which is significantly associated with severe neutropenia.G-CSF therapy exerts an assistant role to antibiotics in controlling the infection.