急性白血病患者肺炎克雷伯菌所致严重社区获得性肺炎临床病程特点

V. I. Saharov, P. Mironov, I. Lutfarakhmanov, T. Ikromov
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摘要

目的:比较急性淋巴母细胞白血病和髓母细胞白血病患者肺炎致重度社区获得性肺炎的病程。材料和方法。该研究设计为回顾性、单中心、对照和非随机研究,包括40例患者。将患者分为急性髓母细胞白血病患者22例(死亡率59%)和急性淋巴母细胞白血病患者18例(死亡率38%)两组。结果和讨论。与急性淋巴细胞白血病相比,急性髓母细胞白血病合并由Kl.肺炎引起的严重社区获得性肺炎表现出更高的死亡率,更长的呼吸支持时间,以及在感染过程中更频繁地累及器官和系统。结论:急性髓母细胞白血病患者肺炎的发展具有病程较重的特点。SOFA、APACHE-II和PSI/PORT量表对Kl肺炎引起的急性白血病和严重社区获得性肺炎患者的预测能力有限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of the clinical course of severe community-acquired pneumonia caused by Klebsiella pneumoniae in patients with acute leukemia
Aim: To compare the course of severe community-acquired pneumonia caused by Kl. pneumonia in patients with acute lymphoblastic and myeloblastic leukaemia.Materials and methods. The study was designed as a retrospective, single-centre, controlled and non-randomized study and included 40 patients. They were divided into two groups: patients with acute myeloblastic leukaemia (22), mortality of 59% (13 patients) and patients with acute lymphoblastic leukaemia (18), mortality of 38% (7 patients).Results and discussion. The combination of acute myeloblastic leukaemia and severe community-acquired pneumonia caused by Kl. pneumonia showed a higher mortality rate, a longer duration of respiratory support, as well as a greater frequency of involvement of organs and systems in the infectious process than in acute lymphoblastic leukaemia.Conclusions: The development of pneumonia caused by Kl. pneumonia in patients with acute myeloblastic leukaemia is characterized by a more severe course. SOFA, APACHE-II, and PSI/PORT scales have limited predictive ability in patients with acute leukaemia and severe community-acquired pneumonia caused by Kl. Pneumoniae. 
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