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质子泵抑制剂与血液系统恶性肿瘤患者化疗后肠道源性菌血症发生的关联

Association of proton pump inhibitors with the occurrence of gut-derived bacteraemia in patients with haematological malignancy after chemotherapy.

作者信息

Zhou Shu-Juan, Wang Si-Qian, Ma Yong-Yong, Tang Li-Yuan, Shi Yi-Fen, Liang Bin, Chen Yi, Yu Kang

机构信息

a Department of Hematology , The First Affiliated Hospital of Wenzhou Medical University , Zhejiang 325000 , P.R. China.

b Department of Prosthodontics, School & Hospital of Stomatology , Wenzhou Medical University , Zhejiang 325000 , P.R. China.

出版信息

Hematology. 2016 Jul;21(6):332-7. doi: 10.1080/10245332.2016.1142711. Epub 2016 Mar 10.

Abstract

BACKGROUND

Gut-derived bacteraemia is a major complication in patients with haematological malignancy after chemotherapy.

OBJECTIVE

Our study aimed to investigate the role of proton pump inhibitors (PPIs) in the occurrence of gut-derived bacteraemia.

METHODS

We compared data from 92 hospitalized haematological malignancy patients after chemotherapy with gut-derived bacteraemia, collected from January 2009 to July 2015, with those of 92 contemporaneous, hospitalized haematological malignancy patients without bacteraemia. We evaluated PPIs use and analysed the effects of covariates.

RESULTS

Patients with gut-derived bacteraemia had a significantly higher incidence of PPIs use (69.6%) than that of controls (47.8%). Of the patients with gut-derived bacteraemia, only 44.6% had a documented indication for PPIs therapy. The antibacterial prophylaxis rate was 38.0% in the bacteraemia group and 58.7% in the non-antibacterial group. Based on multivariable logistic regression analysis, only PPIs use (P = 0.00, odds ratio (OR) = 0.546) was found to be associated with the risk of bacteraemia whereas antibacterial prophylaxis (P = 0.00, OR = 0.652) was protective. There were no significant differences in demographics, malignancy status, length of neutropenia, complications, or steroid use between the gut-derived bacteraemia and control group.

CONCLUSIONS

This study suggests a potential association between PPIs use and development of gut-derived bacteraemia in haematological malignancy patients after chemotherapy.

摘要

背景

肠道源性菌血症是血液系统恶性肿瘤患者化疗后的主要并发症。

目的

我们的研究旨在调查质子泵抑制剂(PPIs)在肠道源性菌血症发生中的作用。

方法

我们比较了2009年1月至2015年7月收集的92例化疗后发生肠道源性菌血症的住院血液系统恶性肿瘤患者的数据与同期92例未发生菌血症的住院血液系统恶性肿瘤患者的数据。我们评估了PPIs的使用情况并分析了协变量的影响。

结果

肠道源性菌血症患者使用PPIs的发生率(69.6%)显著高于对照组(47.8%)。在肠道源性菌血症患者中,只有44.6%有PPIs治疗的记录指征。菌血症组的抗菌预防率为38.0%,非菌血症组为58.7%。基于多变量逻辑回归分析,仅发现使用PPIs(P = 0.00,比值比(OR)= 0.546)与菌血症风险相关,而抗菌预防(P = 0.00,OR = 0.652)具有保护作用。肠道源性菌血症组与对照组在人口统计学、恶性肿瘤状态、中性粒细胞减少持续时间、并发症或类固醇使用方面无显著差异。

结论

本研究表明,血液系统恶性肿瘤患者化疗后使用PPIs与肠道源性菌血症的发生之间可能存在关联。

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