去甲氧柔红霉素联合阿糖胞苷诱导化疗期间急性髓系白血病患者感染发生情况及危险因素分析OA

Objective To investigate the occurrence of infection and risk factors in patients with acute myeloid leukemia(AML)during induction chemotherapy with idarubicin plus cytarabine(IA)regimen.Methods A total of 172 AML patients admitted to Fuyang People's Hospital Affiliated to Anhui Medical University from January 2021 to June 2025 were selected as the research subjects,and all patients received IA induction chemotherapy.According to whether nosocomial infection occurred during treatment,the patients were divided into an infection group(n=70)and a non-infection group(n=102).The clinical data and test indicators of the two groups were compared.Sputum or other secretions of infected patients were collected for pathogenic microorganism culture,and the infection sites and pathogenic detection results were recorded in detail.A multivariate general Logistic regression model was used to analyze the influencing factors of nosocomial infection,a nomogram model was established,and the fitting effect of the prediction model was evaluated by calibration curve.Results The age,length of hospital stay,proportion of patients with≥2 chemotherapy cycles,proportion of patients without prophylactic use of antibiotics,incidence of hypoproteinemia,and proportion of patients with agranulocytosis duration≥7 days in the infection group were all higher than those in the non-infection group(P<0.05),while the white blood cell count was lower than that in the non-infection group(P<0.05).The results of multivariate general Logistic regression analysis showed that longer length of hospital stay[O^R=1.472(95%CI:1.294,1.675)],longer agranulocytosis duration[O^R=3.650(95%CI:1.491,8.940)],and hypoproteinemia[O^R=3.351(95%CI:1.353,8.301)]were risk factors for nosocomial infection in AML patients during IA induction chemotherapy(P<0.05),and prophylactic use of antibiotics[O^R=0.233(95%CI:0.097,0.559)]was a protective factor(P<0.05).Conclusion Long length of hospital stay,agranulocytosis duration≥7 days,and complicated hypoproteinemia are the main risk factors for nosocomial infection in AML patients during IA induction chemotherapy,while prophylactic use of antibiotics can reduce the infection risk.