【摘要】 目的分析急性白血病并发念珠菌败血症的临床特征,探讨其早期死亡的危险因素。方法选取中山大学附属第三医院血液内科诊治的9例急性白血病并发念珠菌败血症患者,并根据转归分为存活组与死亡组,对临床资料进行回顾性分析。结果存活组发热前粒细胞缺乏时间短于死亡组,差异有统计学意义(P=0.046);存活组与死亡组降钙素原(PCT)、C-反应蛋白最高值(CRP-MAX)、降钙素原最高值(PCT-MAX)、1,3-β-D葡聚糖(BDG)-MAX差异有统计学意义(P=0.004、0.008、0.005、0.015),在临床表现、真菌预防与否、治疗方法、C-反应蛋白(CRP)、红细胞沉降率(ESR)、红细胞沉降率最高值(ESR-MAX)、BDG之间的差异无统计学意义(P>0.05)。结论更长时间的粒细胞缺乏后出现念珠菌败血症、白色念珠菌感染、更高的PCT、PCT-MAX、CRP-MAX及BDG-MAX等是念珠菌败血症的不良预后因素。更多还原

【Abstract】 Objective To analyze the clinical features and explore the risk factors of early death of acute leukemia patients complicated with candidemia.Methods We retrospectively analyzed the clinical data of 9 patients with acute leukemia complicated with candidemia who was diagnosed and treated in department of Hemopathology in the Third affiliated Hospital of Sun Yat-sen University and those patients were divided into survival group and death group according to their outcome.ResultsThe time of neutropenia before fever of survival group shorter than death group(P=0.046).The differences of procalcitonin(PCT),the maximum of C-reactive protein(CRP-MAX),the maximum of PCT(PCT-MAX)and the maximum of 1,3-β-D glucan(BDG-MAX)between survival group and death group were statistically significant(P=0.004,0.008,0.005,0.015).There were no statistical significant differences in clinical manifestations,fungi prevention,treatment methods,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),the maximum of ESR(ESR-MAX)and BDG between survival group and death group(P>0.05).Conclusion The longer time of neutropenia before Candida septicaemia,Candida albicans infection and higher PCT,PCT-MAX,CRP-MAX,BDG-MAX were poor prognostic factors of candidemia.更多还原