中国循证医学杂志

中国循证医学杂志

乳腺癌和肺癌患者化疗后 Ⅳ 度粒细胞减少继发感染危险因素的病例-对照研究

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目的 分析乳腺癌和肺癌患者化疗后 Ⅳ 度粒细胞减少继发感染的危险因素,为制定预防乳腺癌和肺癌患者化疗后继发感染的措施提供参考依据。 方法 采用病例-对照试验设计,以 2014 年 1 月~2014 年 12 月西安交通大学第一附属医院化疗 Ⅳ 度粒细胞减少继发感染的乳腺癌、肺癌 37 例患者为病例组,以同期化疗 Ⅳ 度粒细胞减少未继发感染的乳腺癌、肺癌患者 87 例为对照组,通过回顾性收集病历资料,采用单因素和 Logistic 回归分析 Ⅳ 度粒细胞减少患者继发感染的危险因素。 结果 单因素分析结果显示,MASCC 评分<21 的 Ⅳ 度粒细胞减少患者感染风险更高(P<0.05),乳腺癌 Ⅳ 度粒细胞减少患者,前两个化疗周期继发感染风险是后续化疗周期的 2.87 倍;对于肺癌 Ⅳ 度粒细胞减少患者,侵入性操作和预防性使用抗菌药物均增加感染风险(P<0.05)。Logistic 回归分析结果表明 MASCC 评分和化疗周期与乳腺癌 Ⅳ 度粒细胞减少患者继发感染显著相关(P<0.05),侵入性操作与预防性使用抗菌药物与肺癌 Ⅳ 度粒细胞减少患者继发感染显著相关(P<0.05)。 结论 MASCC 评分和化疗周期是乳腺癌化疗致 Ⅳ 度减少继发感染的危险因素,肺癌侵入性操作与预防性使用抗菌药物是肺癌 Ⅳ 度粒细胞减少患者继发感染的危险因素。

Objectives To analyze the risk factors of secondary infections in breast cancer or lung cancer patients with chemotherapy-induced degree Ⅳ neutropenia, so as to provide reference for clinical treatment. Methods The case-control study design was used. Thirty-seven in-patients of breast cancer or lung cancer with secondary infections and 87 in-patients without secondary infection in the First Affiliated Hospital of Xi’an Jiaotong University from January to December 2014 were enrolled as study population. We collected the retrospective information and analyzed the risk factors of secondary infection with chemotherapy-induced degree Ⅳ neutropenia using factors under univariate analysis and logistic regression analysis. Results Single factor analysis showed that the patients whose MASCC<21 the had higher infection risks (P<0.05). For breast cancer patients with degree Ⅳ neutropenia, secondary infection risk of first two chemotherapy cycles was 2.87 times of subsequent cycles of chemotherapy. For lung cancer patients with degree Ⅳ neutropenia, invasive procedures and preventive use of antibiotics increased risk of infection (P<0.05). Logistic regression analysis showed MASCC score and chemotherapy cycles were significantly associated with secondary infection in breast cancer degree Ⅳ neutropenia patients (P<0.05). Invasive procedures were significantly correlated to secondary infection of patients with lung cancer degree Ⅳ neutropenia (P<0.05). Conclusions MASCC score and chemotherapy cycles are the risk factors of infection in breast cancer patients with degree Ⅳ neutropenia, and invasive procedures are the independent risk factors of infection in lung cancer patients with degree Ⅳ neutropenia.

关键词: 乳腺癌; 肺癌; 粒细胞减少; 感染; 病例-对照研究

Key words: Breast cancer; Lung cancer; Neutropenia; Infection; Case-control study

引用本文: 樊迪, 尤海生, 李红, 贺银丽, 唐丽娜, 张玮, 吕军. 乳腺癌和肺癌患者化疗后 Ⅳ 度粒细胞减少继发感染危险因素的病例-对照研究. 中国循证医学杂志, 2018, 18(4): 306-310. doi: 10.7507/1672-2531.201706037 复制

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