中国临床药学杂志2026，Vol.35Issue(6)：518-523,6.DOI:10.19577/j.1007-4406.2026.06.007
血液肿瘤患者并发感染的病原学分布及影响因素分析
Analysis of the etiological distribution and influencing factors of infections in patients with hematologic malignancies
摘要
Abstract
AIM To investigate the characteristics of infections,distribution of pathogenic bacteria,and current treatment status in patients with hematological malignancies,and analyze the influencing factors for infection occurrence.METHODS A retrospective study was conducted in which patients with hematologic malignancies who received anticancer treatment at our hospital between January 2023 and December 2024 and subsequently developed an infection were selected to form the infection group.Using a 1∶1 propensity score matching method,an equal number of non-infected patients were selected as the control group.Univariate analysis was used to compare factors such as age,infection prophylaxis,comorbidities,intravenous catheterization,type of hematological malignancies,history of fungal infection,hematopoietic stem cell transplantation,ICU admission,parenteral nutrition,neutrophil level,immunoglobulin level,and CD4+T cell level for their impact on infection occurrence.Variables with P＜0.1 from the above results were included in a logistic regression model for multivariate analysis to identify the independent risk factors for infection.RESULTS A total of 180 patients with hematological malignancies were included.Univariate analysis showed that age,type of hematological malignancies infection prophylaxis,hematopoietic stem cell transplantation,parenteral nutrition,neutrophil level,and immunoglobulin level were associated with infection.Logistic regression analysis revealed that patients with leukemia(OR=4.851,95％CI:1.211-19.432,P=0.026)and low CD4+T cell levels(OR=4.471,95％CI:1.209-16.535,P=0.025)were risk factors for infection,while not undergoing hematopoietic stem cell transplantation(OR=0.040,95％CI:0.006-0.255,P=0.001)served as a protective factor.CONCLUSION Infections in patients with hematologic malignancies primarily manifest as pulmonary infections caused by Gram-negative bacteria(such as Klebsiella pneumoniae and Escherichia coli),which are typically treated with β-lactam antibiotics;leukemia and low CD4+T cell counts are the main risk factors,while the absence of hematopoietic stem cell transplantation is a protective factor.关键词
血液肿瘤/感染/影响因素Key words
hematologic malignancies/infection/influencing factor分类
医药卫生引用本文复制引用
武卓,涂好,冯思敏,叶林萱,丁天凌,王斌..血液肿瘤患者并发感染的病原学分布及影响因素分析[J].中国临床药学杂志,2026,35(6):518-523,6.基金项目
上海市卫健委卫生行业临床研究专项(编号202040424) （编号202040424）
上海市"医苑新星"青年医学人才培养资助计划-临床药师项目资助(编号:沪卫人事[2021]99号) （编号:沪卫人事[2021]99号）
