【作者】 许兰平； 纪宇； 刘代红； 陈育红； 韩伟； 陈瑶； 王昱； 刘开彦； 黄晓军；

【Author】 Xu Lan-ping,Ji Yu,Liu Da-ihong,Chen Yu-hong,Han We,Chen Yao,Wang Yu, Liu Kai-yan,Huang Xiao-jun

【机构】 北京大学人民医院血液科；

【摘要】 目的:了解造血干细胞移植(hematopoietic stem cell transplantation,HSCT)后患者侵袭性真菌感染(invasive fungal infection,IFI)的发病率及危险因素。方法:选择2003年6月至2004年9月于我所进行HSCT的患者148例,按照我国IFI的诊断标准及临床疗效进行回顾性分析。结果:诊断IFI的患者共52例,其中确诊者35例,拟诊者17例。其发生时间为移植后+2天至+400天,中位时间为+62天。确诊IFI在移植后3个月、6个月及1年的累积发病率分别为15.6%、42.5%和48.9%。根据多因素分析,早期IFI的危险因素为:Ⅲ～Ⅳ度的急性移植物抗宿主病(aGVHD)、广谱抗生素的长期应用及巨细胞病毒(CMV)感染;晚期IFI的危险因素为:广泛型慢性移植物抗宿主病(cGVHD)和激素的长期应用。结论:具有较多危险因素的HSCT受者更易发生IFI,而避免或减少上述危险因素,是预防侵袭性真菌感染的有效方法。更多还原

【Abstract】 Objective To examine the incidence and risk factors of invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients.Methods One hundred and forty-eight patients, performed HSCT at this institute from June 2003 to September 2004,were analyzed retrospectively according to the diagnosis criteria of IFI.Results Fifty-two cases of IFI were identified,and there were 35 proven IFI and 17 probable IFI patients.The infection occurred a median of 62 days after HSCT,and the cumulative incidence of proven IFI during the third month,the sixth month and the first year were 15.6%,42.5%and 48.9%respectively. By multivariate analysis,the variable associated with early infection risk were severe acute GVHD,antibiotics and CMV infection,while the chronic extensive GVHD and glucocorticosteroid use were associated with the late-onset IFI.Conclusion The patients who had more risk factors were more likely predispose to IFI,and avoiding the risk factors could reduce the incidence rate of IFI.更多还原