Krepler P
Wien Klin Wochenschr. 1979 Nov 9;91(21):707-15.
Infections of children with malignant disease, especially of the lympho-reticular system, are characterized by their severity, with a high mortality, as a consequence of defective immunocompetence. According to the immunosurveillance theory, temporary immune defects could have even facilitated the malignant growth. The neoplastic disease itself contributes to the immunodeficiency by multiple mechanisms. The powerful cytostatic-cytocidal drugs reduce the immune response also, especially in the phases of bone marrow depression. Granulocytopenia shows the most significant correlation with the incidence of serious infections. The different forms of hospital infections have been reviewed and classified as 1. bacterial, fungal and, rarely, (but most dangerous) protozoal infections, 2. endogenous infections with the patient's own anaerobic intestinal flora and 3. viral infections. The perspectives of up-to-date chemotherapy and management of the immunodeficiency e.g. with leucocyte transfusions, and attempts to prevent infection are discussed.
患有恶性疾病的儿童,尤其是淋巴网状系统疾病患儿,其感染的特点是病情严重,死亡率高,这是免疫能力缺陷所致。根据免疫监视理论,暂时的免疫缺陷甚至可能促进了恶性肿瘤的生长。肿瘤疾病本身通过多种机制导致免疫缺陷。强效的细胞毒性-细胞杀伤药物也会降低免疫反应,尤其是在骨髓抑制阶段。粒细胞减少与严重感染的发生率相关性最为显著。对医院感染的不同形式进行了综述,并分类如下:1. 细菌、真菌以及罕见的(但最危险的)原生动物感染;2. 由患者自身肠道厌氧菌引起的内源性感染;3. 病毒感染。文中还讨论了最新化疗方法以及免疫缺陷的处理方法,如白细胞输注,此外还探讨了预防感染的措施。