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目的:探讨恶性血液病患者并发间质性肺炎的危险因素与预后因素。方法:回顾性研究452例接受标准化疗的恶性血液病患者。结果:452例患者中有36例并发间质性肺炎,发生率为7.96%。粒细胞缺乏≥7d的患者中,间质性肺炎的发生率为12.75%。并发真菌感染的患者中,间质性肺炎的发生率为40.00%。恶性血液病患者并发间质性肺炎的病死率为55.56%。粒细胞缺乏≥7d的间质性肺炎患者,病死率达69.23%。并发真菌感染的间质性肺炎患者,病死率为80.00%。14例粒细胞恢复正常者全部存活。加用激素治疗的患者,病死率14.29%。结论:粒细胞缺乏≥7d、真菌感染是恶性血液病患者化疗后并发间质性肺炎的危险因素。粒细胞缺乏≥7d、真菌感染者预后差,粒细胞恢复正常者预后良好,激素治疗可以改善预后。
Objective: To investigate the risk factors and prognostic factors of interstitial pneumonia in patients with hematologic malignancies. Methods: A retrospective study of 452 patients receiving standard chemotherapy for hematologic malignancies. RESULTS: Thirty-six of 452 patients had interstitial pneumonia with a rate of 7.96%. Among patients with agranulocytosis ≥7 days, the incidence of interstitial pneumonia was 12.75%. In patients with fungal infections, the incidence of interstitial pneumonia was 40.00%. The mortality rate of interstitial pneumonia in patients with hematologic malignancies was 55.56%. Granulocytoma ≥ 7d interstitial pneumonia patients, the mortality rate of 69.23%. Concurrent fungal infection in patients with interstitial pneumonia, the case fatality rate was 80.00%. All 14 patients with normal granulocytes survived. Plus hormone therapy in patients with fatality rate of 14.29%. CONCLUSION: FML is more than 7 days. Fungal infection is a risk factor for interstitial pneumonia in patients with hematologic malignancies after chemotherapy. Agranulocytosis ≥ 7d, fungal infection, poor prognosis, normal return of granulocytes with good prognosis, hormone therapy can improve prognosis.