地西他滨单药或联合低剂量化疗治疗老年急性髓系白血病医院内感染.doc

·……专栏· 地西他滨单药或联合低剂量化疗治疗老年急性髓系白血病医院内感染的临床分析 周宏伟, 古永建, 王志红, 刘 默, 曹志刚, 彭朝津, 杜 瑜, 杨清明* （解放军总医院第一附属医院老年血液肿瘤科, 北京 100048） 【摘 要】目的 分析地西他滨单药或联合低剂量化疗治疗老年急性髓系白血病医院内感染的临床特点及易感因素。方法 回顾性分析2009年9月至2012年10月接受地西他滨单药或联合低剂量化疗治疗的10例老年急性髓系白血病患者医院内感染发生率、感染部位、致病菌和易感因素等。结果 10例老年患者治疗后医院内感染率为70%，例次感染率为46.7%，感染部位以呼吸系统最多见（52.4%），致病菌以革兰阴性杆菌为主。化疗后骨髓抑制、粒细胞减少者感染率明显增高；与联合低剂量化疗方案比较，地西他滨单药方案骨髓抑制、粒细胞减少发生率和医院内感染率降低。结论 老年急性髓系白血病患者是医院内感染的易感人群，骨髓抑制、粒细胞减少是易感因素。地西他滨单药方案治疗老年急性髓系白血病可降低医院内感染发生率。 【关键词】地西他滨; 老年人; 白血病, 髓样, 急性; 医院内感染; 粒细胞减少症 【中图分类号】 R733.7; R592 【文献标识码】 A 【DOI】 ? Clinical analysis on nosocomial infection in elderly acute myeloid leukemia patients treated by decitabine with or without low-dose chemotherapy ZHOU Hong-Wei, GU Yong-Jian, WANG Zhi-Hong, LIU Mo, CAO Zhi-Gang, PENG Chao-Jin, DU Yu, YANG Qing-Ming* (Department of Geriatric Hematology and Oncology, First Affiliated Hospital of PLA General Hospital, Beijing 100048, China) 【Abstract】 Objective To investigate the clinical characteristics and susceptible factors of nosocomial infection in the elderly patients with acute myeloid leukemia treated by decitabine with or without low-dose chemotherapy. Methods A retrospective analysis was carried out on 10 elderly patients with acute myeloid leukemia who were treated by decitabine with or without low-dose chemotherapy in our department from September 2009 to October 2010. The incidence of nosocomial infection, most commonly infected sites, pathogenic bacteria and the susceptible factors were collected and analyzed in the cohort during the chemotherapeutic period. Results The incidence of nosocomial infection was 70%, and case infection rate was 46.7% in this study. The most commonly infected site was respiratory system, accounting for 52.4%, and the common pathogenic bacteria were mainly Gram-negative ones. There was a markedly increased infection rate in the patients with myelosuppression and neutropenia. The incidence of myelosuppression and neutropenia was lower in the re