血液病患者侵袭性真菌感染危险评分系统的建立

发布时间：2019-08-14 12:01:29 来源：文档文库

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血液病患者侵袭性真菌感染危险评分系统的建立
作者：孙海燕刘飞宇张雷赵莉徐磊
来源：《中国药房》2018年第09期

中圖分类号 R978.1+1 文献标志码 A 文章编号 1001-0408（2018）09-1270-04

DOI 10.6039/j.issn.1001-0408.2018.09.29

摘要目的：建立识别血液病患者侵袭性真菌感染（IFI）高风险人群的风险评分系统。方法：对2008年1月-2015年12月200例诊断为IFI患者的病例资料和同时期200例对照病例进行危险因素调查，对可能的危险因素进行单因素及Logistic多因素回归分析，筛选出IFI的危险因素并分别赋值。建立IFI风险评分系统，运用接收者工作特征曲线（ROC）评价该评分系统的效能。运用该评分系统对2016年1-6月的103例患者（验证组）进行评分，并比较各得分组IFI发生率。利用评分系统对18例高危患者（干预组）进行干预。结果：社区获得性感染、中性粒细胞降低、真菌感染病史、糖皮质激素、广谱抗菌药物（加酶抑制剂、糖肽类、喹诺酮类、氨基糖苷类和碳青霉烯类）是IFI的危险因素（P

关键词血液病患者；侵袭性真菌感染；评分系统；效能分析；广谱抗菌药物；干预

ABSTRACT OBJECTIVE： To establish a risk scoring system for identifying invasive fungal infection（IFI）patients with hematologic diseases. METHODS： Risk factors were investigated among 200 patients diagnosed with IFI and 200 control patients at the same time from Jan. 2008 to Dec. 2015. The single factor analysis and Logistic multivariate regression analysis were conducted for potential risk factors to screen and assign risk factors of IFI. The risk scoring system of IFI was established，the performance of scoring system was evaluated by receiver operating characteristic （ROC） curve. Using the scoring system， 103 patients of validation group were scored during Jan. to Jun. in 2016. The incidence of IFI in each group was compared. 18 high-risk patients were intervened by the scoring system. RESULTS： Community acquired infection， the reduction of neutrophils， fungal infection history， corticosteroids and broad-spectrum antibiotics （Enzyme inhibitors， glycopeptides， quinolones， aminoglycosides and carbapenems） were risk factors of IFI （P