中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
10期
773-777
,共5页
朱宇%王力%冯莎娜%王帅%郑翠玲%王景智%杜春霞%冯云%李丹
硃宇%王力%馮莎娜%王帥%鄭翠玲%王景智%杜春霞%馮雲%李丹
주우%왕력%풍사나%왕수%정취령%왕경지%두춘하%풍운%리단
肿瘤%艰难梭菌%腹泻
腫瘤%艱難梭菌%腹瀉
종류%간난사균%복사
Neoplasms%Clostridium difficile%Diarrhea
目的 探讨肿瘤患者中艰难梭菌相关性腹泻(CDAD)的发病情况及其危险因素.方法 收集2010年9月至2011年12月间277例恶性肿瘤患者腹泻的粪便标本,进行艰难梭菌毒素A/B检测、粪便厌氧培养和粪便常规检测,并对艰难梭菌阳性患者的临床病理特征和实验室检查结果进行单因素和多因素分析.结果 277例肿瘤腹泻患者中,共检出艰难梭菌毒素阳性者41例(14.8%),其中艰难梭菌毒素检测和艰难梭菌培养同时阳性11例,占26.8%(11/41).单因素分析结果显示,应用抗生素、应用质子泵抑制剂、低蛋白血症和全血白细胞水平与肿瘤患者CDAD的发生均无关(均P>0.05);肿瘤患者接受化疗、接受放疗、粪便潜血阳性和粪便白细胞镜检阳性与CDAD的发生均有关(均P<0.05).多因素分析结果显示,接受化疗和粪便潜血阳性是肿瘤患者发生CDAD的独立危险因素(均P<0.05).结论 接受化疗、粪便潜血阳性是肿瘤患者发生CDAD的独立危险因素.应定期对接受化疗和粪便潜血阳性的肿瘤患者进行粪便艰难梭菌毒素A/B检测和厌氧培养,预防CDAD的发生.
目的 探討腫瘤患者中艱難梭菌相關性腹瀉(CDAD)的髮病情況及其危險因素.方法 收集2010年9月至2011年12月間277例噁性腫瘤患者腹瀉的糞便標本,進行艱難梭菌毒素A/B檢測、糞便厭氧培養和糞便常規檢測,併對艱難梭菌暘性患者的臨床病理特徵和實驗室檢查結果進行單因素和多因素分析.結果 277例腫瘤腹瀉患者中,共檢齣艱難梭菌毒素暘性者41例(14.8%),其中艱難梭菌毒素檢測和艱難梭菌培養同時暘性11例,佔26.8%(11/41).單因素分析結果顯示,應用抗生素、應用質子泵抑製劑、低蛋白血癥和全血白細胞水平與腫瘤患者CDAD的髮生均無關(均P>0.05);腫瘤患者接受化療、接受放療、糞便潛血暘性和糞便白細胞鏡檢暘性與CDAD的髮生均有關(均P<0.05).多因素分析結果顯示,接受化療和糞便潛血暘性是腫瘤患者髮生CDAD的獨立危險因素(均P<0.05).結論 接受化療、糞便潛血暘性是腫瘤患者髮生CDAD的獨立危險因素.應定期對接受化療和糞便潛血暘性的腫瘤患者進行糞便艱難梭菌毒素A/B檢測和厭氧培養,預防CDAD的髮生.
목적 탐토종류환자중간난사균상관성복사(CDAD)적발병정황급기위험인소.방법 수집2010년9월지2011년12월간277례악성종류환자복사적분편표본,진행간난사균독소A/B검측、분편염양배양화분편상규검측,병대간난사균양성환자적림상병리특정화실험실검사결과진행단인소화다인소분석.결과 277례종류복사환자중,공검출간난사균독소양성자41례(14.8%),기중간난사균독소검측화간난사균배양동시양성11례,점26.8%(11/41).단인소분석결과현시,응용항생소、응용질자빙억제제、저단백혈증화전혈백세포수평여종류환자CDAD적발생균무관(균P>0.05);종류환자접수화료、접수방료、분편잠혈양성화분편백세포경검양성여CDAD적발생균유관(균P<0.05).다인소분석결과현시,접수화료화분편잠혈양성시종류환자발생CDAD적독립위험인소(균P<0.05).결론 접수화료、분편잠혈양성시종류환자발생CDAD적독립위험인소.응정기대접수화료화분편잠혈양성적종류환자진행분편간난사균독소A/B검측화염양배양,예방CDAD적발생.
Objective The aim of this study was to investigate the prevalence of Clostridium difficile (C.difficile) infection and the risk factors for acquisition of C.difficile-associated diarrhea(CDAD) among cancer patients who received chemotherapy or radiation therapy.Methods We analyzed 277 stool samples from cancer patients with diarrhea between Sep 2010 and Dec 2011 in our hospital.Stool C.difficile toxin A/B test,stool culture for C.difficile and routine stool examination were performed.In addition,the risk factors for CDAD were investigated in a set of 41 C.difficile toxin-positive cancer patients and 82 matched C.difficile toxin-negative controls by univariate analysis and multivariate analysis.Results Out of a total of 277 cancer patients with diarrhea,41 (14.8%) were C.difficile toxin-positive.Among these 41 cases,11 (26.8%,11/41) were C.difficile culture-positive.Univariate analysis showed that antibiotics use(P =0.853),proton pump inhibitor use(P =0.718),hypoproteinemia (P =0.139) and white blood cell count (P =0.454) did not appear to be associated with acquisition of CDAD in cancer patients.However,receiving chemotherapy (P =0.023),receiving radiotherapy (P =0.003),a positive fecal occult blood test result(P =0.005) and the presence of fecal leukocytes (P =0.007) showed close association with acquisition of CDAD in cancer patients.Multivariate analysis showed that receiving chemotherapy (OR,8.308;95% CI,1.997-34.572;P =0.004) and a positive result of fecal occult blood test(OR,8.475; 95% CI,1.463-49.109;P =0.017) were independent risk factors for acquisition of CDAD among cancer patients.Conclusions Our results support that receiving chemotherapy and a positive fecal occult blood test result are independent risk factors for acquisition of CDAD among cancer patients.Cancer patients who are at high-risk for CDAD should take stool C.difficile toxin A/B test and stool culture for C.difficile regularly and prevention of CDAD.