糖皮质激素治疗特发性血小板减少性紫癜发生感染的危险因素

目的:评估应用糖皮质激素治疗特发性血小板减少性紫癜(ITP)发生感染的危险因素。方法:回顾了我院收治的98例患者经糖皮质激素治疗的临床资料,对是否伴有糖尿病及患者年龄进行相对危险度分析;对用药疗程及感染的发生和严重程度进行相关性分析。结果:98例经糖皮质激素治疗的患者,有21例发生感染,其中2例患者因重症感染死亡。合并糖尿病ITP患者发生感染的相对危险度为14.709(95%CI,4.788-46.984,x2=25.107,P=0.000),老年ITP患者发生感染的相对危险度为4.754(95%CI,1.321-17.102,x2=5.85,P=0.017)。用药疗程与感染的发生及严重程度的相关性均具有统计学意义(r=0.505,P=0.000及r=0.515,P=0.000)。结论:ITP患者合并糖尿病和老年患者是应用糖皮质激素发生感染的危险因素。用药疗程与感染的发生及严重程度均密切相关。

The risk factors of infection in patients with idiopathic thrombocytopenic purpura during treatment of glucocorticoids

Objective:To evaluate risk factors of infection in patients with idiopathic thrombocytopenic purpura(ITP)during treatment of glucocorticoids.Methods:The occurence of infections to 98 cases with ITP were analyzed retrospectively during the treatment of glucocorticoids.The relative risks to concomitance of diabetes mellitus and the age of patients were evaluated.The correlations between treatment duration and infection events as well as its severity were analyzed.Results:Twenty-one cases of 98 patients occurred infections and two patients of them died of severe infections during the treatment.The odds ratio of concomitance diabetes mellitus for infections was 14.709(95%CI,4.788-46.984,x2=25.107,P=0.000).The elderly patients were 4.754(95%CI,1.321-17.102,x2= 5.85,P=0.017).The correlations between treatment duration and infection events as well as its severity had statistical significance(r= 0.505,P=0.000 and r=0.515,P=0.000,respectively).Conclusion:Concomitance diabetes mellitus and the elderly of patients with ITP are risk factors for occurrence of infections during the treatment of glucocorticoids.There are closely correlations between treatment duration and infection events as well as its severity.