儿童急性淋巴细胞白血病化疗后骨髓抑制期重症感染的危险因素分析

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Abstract Objective To explore the risk factors of severe infection in the bone marrow suppression phase after chemotherapy of childhood acute lymphoblastic leukemia (ALL).Methods In this study,90 newly diagnosed children with ALL admitted to Zhongshan Hospital Affiliated to Sun Yat-sen University from January 2017 to January 2020 were selected as the research objects,and were divided into the infection group (n=63) according to whether infection occurred during the bone marrow suppression phase after chemotherapy and the non-infected group (n=27),was divided into a severely infected group (n=24) and a non-severely infected group (n=39) according to whether severe infection occurred during the bone marrow suppression phase after chemotherapy.Logistics was used to analyze the risk factors of severe infection in the myelosuppressive phase of children with ALL after chemotherapy.Results After chemotherapy in children with ALL,the time of neutrophil deficiency in the infection group during the myelosuppression stage was longer than that in the non-infected group,the incidence of skin and mucosal damage was higher than that in the noninfected group,in the infection group,the neutrophil count and hemoglobin levels were lower than those of the non-infected group,the differences were statistically significant (t=21.772,P=0.000; χ2=4.120,P=0.042; t=15.669,P=0.000;t=2.070,P=0.041).The univariate analysis showed that the neutrophil deficiency in the severe infection group was longer than that in the non-severe infection group,the incidence of skin and mucosal damage was higher than that in the non-severe infection group,and the neutrophil count and hemoglobin levels were lower than those in the non-severe infection group,the differences were statistically significant (t=3.251,P=0.000; χ2=10.470,P=0.001; t=22.907,P=0.000; t=3.893,P=0.000).Multivariate Logistic regression analysis showed that the main risk factors for severe infection in the myelosuppressive phase of childhood ALL after chemotherapy were low neutrophil count,long neutrophil deficiency,high incidence of skin and mucosal damage,and low hemoglobin level (P＜0.05).Conclusion Low neutrophil count,long neutrophil deficiency,high incidence of skin and mucosal damage,and low hemoglobin levels are risk factors for severe infection in the myelosuppressive phase of childhood ALL after chemotherapy,and the risk of severe infection in children should be addressed factors are targeted for prevention and control to reduce the incidence of severe infections in the myelosuppressive phase of childhood ALL after chemotherapy and improve the prognosis of children.

Key words： Childhood acute lymphoblastic leukemia Chemotherapy Bone marrow suppression Severe infection Risk factors

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