急性髓系白血病(AML)院内感染的相关因素分析

Analysis of Related Factors of Nosocomial Infection in Patients with Acute Myeloid Leukemia

摘要: 目的：探究急性髓系白血病(Acute myelogenous leukemia, AML)院内感染的相关因素，及时给予早期诊断和早期治疗。方法：回顾性分析自2011年1月至2020年1月收治我院血液科的131例患者，根据是否存在院内感染进行分组，即感染组和非感染组。感染组AML患者64例，包括30例男性，34例女性；非感染组AML患者67例，包括32例男性，35例女性。统计并记录患者的一般基准资料，凝血指标，利用单因素分析和Logistic回归性分析，多因素分析，评估相关因素。结果：结果显示，WBC，APTT，PT，D-D，FIB和血红蛋白是影响AML患者院内感染的相关因素(P < 0.05)。相关因素赋值如下：WBC < 2.0 × 10⁹/L为1，WBC ≥ 2.0 × 10⁹/L为2；APTT < 33 s为1，APTT ≥ 33 s为2；PT < 10 s为1，PT ≥ 10 s为2；D-D < 0.2 ng/L为1，D-D ≥ 0.2 ng/L为2；FIB < 4 g/L为1，FIB ≥ 4 g/L为2；血红蛋白 < 60 g/L为1，血红蛋白 ≥ 60 g/L为2。多因素分析结果显示，WBC ≥ 2.0 × 10⁹/L，APTT ≥ 33 s，PT ≥ 10 s，D-D ≥ 0.2 ng/L，FIB ≥ 4 g/L和血红蛋白 < 60 g/L是影响AML患者院内感染的危险因素。结论：WBC ≥ 2.0 × 109/L，APTT ≥ 33 s，PT ≥ 10 s，D-D ≥ 0.2 ng/L，FIB ≥ 4 g/L和血红蛋白 < 60 g/L是影响AML患者院内感染的危险因素，应及时给予早期诊断和早期治疗。

Abstract: Objective: To explore the related factors of nosocomial infection in acute myelogenous leukemia (AML), and to give early diagnosis and treatment. Methods: From January 2011 to January 2020, 131 patients in the Department of Hematology of our hospital were retrospectively analyzed. They were divided into infection group and non infection group according to whether there was nosocomial infection. In the infection group, there were 64 AML patients, including 30 males and 34 females. There were 67 AML patients in non infection group, including 32 males and 35 females. The general baseline data and coagulation indexes of the patients were recorded. Univariate analysis, logistic regression analysis and multivariate analysis were used to evaluate the related factors. Results: The results showed that WBC, APTT, PT, D-D, FIB and hemoglobin were the related factors of nosocomial infection in AML patients (P < 0.05). The related factors were assigned as follows: WBC < 2.0 × 10⁹ / L is 1, WBC ≥ 2.0 × 109/L is 2; APTT < 33 s is 1, APTT ≥ 33 s is 2; PT < 10 s is 1, PT ≥ 10 s is 2; D-D < 2 ng/L is 1, D-D ≥ 0.2 ng/L is 2; FIB < 4 g/L is 1, FIB ≥ 4 g/L is 2; hemoglobin < 60 g/L is 1, hemoglobin ≥ 60 g/L is 2. The results of multivariate analysis showed that WBC ≥ 2.0 × 10⁹/L, APTT ≥ 33 s, PT ≥ 10 s, D-D ≥ 0.2 ng/L, FIB ≥ 4 g/L and hemoglobin < 60 g/L were risk factors for nosocomial infection in AML patients. Conclusion: WBC ≥ 2.0 × 10⁹/L, APTT ≥ 33 s, PT ≥ 10 s, D-D ≥ 0.2 ng/L, FIB ≥ 4 g/L and hemoglobin < 60 g/L are the risk factors of nosocomial infection in AML patients. Early diagnosis and treatment should be given in time.