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目的探讨初治多发性骨髓瘤(MM)老年患者化疗后感染的临床特点、易感因素及对预后的影响,以降低感染率。方法对2000年2月-2013年3月85例初治老年MM患者化疗后感染的临床资料进行回顾性分析,所有数据采用SPSS 13.0软件进行统计分析。结果患者化疗后感染45例,感染率为52.9%;64.4%的感染发生于第一个疗程后,PD方案与传统化疗方案相比感染率差异无统计学意义;感染部位以呼吸道感染最多见;36例患者检出病原菌52株,其中革兰阴性杆菌占44.2%、革兰阳性球菌占19.2%、真菌占36.6%;肾功能不全、低白蛋白血症、粒细胞减少、ECOG评分≥3分为感染的易感因素。结论老年多发性骨髓瘤患者是化疗后感染的高危人群,感染后生存期短、早期病死率高,化疗期间需加强免疫保护。
Objective To investigate the clinical features, susceptibility factors and prognosis of elderly patients with multiple myeloma (MM) after initial chemotherapy to reduce the infection rate. Methods The clinical data of 85 cases of newly diagnosed elderly patients with MM after chemotherapy from February 2000 to March 2013 were retrospectively analyzed. All the data were analyzed by SPSS 13.0 software. Results 45 cases were infected with chemotherapy after infection, the infection rate was 52.9%. 64.4% of the infections occurred after the first course of treatment. There was no significant difference in the infection rates between the PD and traditional chemotherapy regimens. The most common respiratory infection was in the infected sites. Among the 36 patients, 52 strains of pathogens were detected, of which Gram-negative bacilli accounted for 44.2%, Gram-positive cocci accounted for 19.2% and fungi accounted for 36.6%. Renal insufficiency, hypoalbuminemia, neutropenia and ECOG score ≥3 Susceptible factors for infection. Conclusions Elderly patients with multiple myeloma are high-risk patients who have been infected after chemotherapy. Their survival after infection is short, their early mortality is high, and their immune protection needs to be strengthened during chemotherapy.