儿童急性淋巴细胞白血病营养状况与感染相关性研究

A Correlation Study on Nutritional Status and Infection in Children with Acute Lymphoblastic Leukemia

摘要: 目的：研究儿童急性淋巴细胞白血病(Acute Lymphoblastic Leukemia, ALL)化疗期间营养状况及感染的特点，分析营养状况与感染的关系。方法：选择2020年12月至2021年8月青岛大学附属医院儿童血液肿瘤科44例ALL诊断明确并按CCCG-ALL-2020方案治疗的儿童作为研究对象，搜集他们的临床资料(年龄、性别、危险度、化疗阶段)、营养状况(体重、身高、体质指数BMI及其Z值)以及住院期间感染情况(感染病程、抗生素使用情况、实验室指标、感染部位等)，运用秩和检验进行统计学分析。结果：44例ALL儿童，共171个化疗阶段，消瘦/严重消瘦发生率8.77%，肥胖发生率4.10%；感染例次率64.33% (110/171)，其中诱导缓解PVDL期、诱导缓解CAT期感染例次率居高，分别为25.15% (43/171)、16.37% (28/171)。感染部位以呼吸道最多见，占40.91%。营养状况、中性粒细胞、血红蛋白、血小板对感染严重程度具有影响，P < 0.05。消瘦/严重消瘦以及肥胖患儿较正常营养状况儿童感染程度重。结论：急性淋巴细胞白细胞儿童化疗期间，中性粒细胞、血红蛋白、血小板、营养状况对感染严重程度具有影响。营养状况越差，感染程度越重。

Abstract: Objective: To investigate the nutrition and infection characteristics of children with Acute Lymphoblastic Leukemia (ALL) during chemotherapy, and to analyze the relationship between nutrition and infection. Methods: 44 children with ALL were selected as the research object, who were diagnosed and treated according to CCCG-ALL-2020 in the Affiliated Hospital of Qingdao University from December 2020 to August 2021. The clinical data (age, gender, risk level, chemotherapy stage), nutritional status (weight, height, body mass index, BMI and BMI-Z) and infection during hospitalization (course of infection, application of antibiotics, laboratory indicators, sites of infection.) were collected. The rank sum test was used for statistical analysis. Results: There were 44 children with ALL, a total of 171 chemotherapy stages. The incidence of weight loss/severe weight loss was 8.77%, and the incidence of obesity was 4.10%. The incidence of infection was 64.33% (110/171), and the infection rates of PVDL and CAT were high, 25.15% (43/171) and 16.37% (28/171) respectively. Respiratory infection was the most common, accounting for 40.91%. Nutritional status, neutrophils, hemoglobin and platelets had an effect on the severity of infection (P < 0.05). Children with weight loss/severe weight loss and obesity had more severe infection than children with normal nutritional status. Conclusion: Nutritional status, neutrophils, hemoglobin and platelets had an effect on the severity of infection during chemotherapy in children with Acute Lymphoblastic Leukemia. The worse the nutritional status, the more severe the infection.