Research Of Invasive Pulmonary Fungal Infection Related To Hematologic Malignancies

ObjectiveTo analyse the clinical data and treatment of patients with invasive pulmonaryfungal infection related to hematologic malignanices, and to discuss the value of thelevel of White blood cell(WBC), Neutrophil (NEU), C-reactive protein (CRP)andProcalcitonin (PCT) in evaluating the severity and prognosis of the disease.MethodsA total of52patients with invasive pulmonary fungal infection related tohematologic malignanices hospitalized in the First Affiliated Hospital of ZhengzhouUniversity from November2012to March2014were enrolled in this study,52patients were divided into two groups according to the treatment effect, Twenty-ninesubjects in the better-treatment group, twenty-three subjects in the worsen-treatmentgroup.To observe and collect the clinical data of the clinical manifestation, signs, theroutine inspection (blood routine examination,liver function,renal function), thefungus examination(G-test,GM-test),the inflammation marks(CRP, PCT) and thechest imaging findings in the two group.The level of WBC, NEU, CRP, PCT werecompared between the two groups. Results1．The patients in the study, the age and gender in the two group have nosignificant difference(P﹥0.05).2．Clinical Characteristics In the two groups, the sysmptom of fever, chestdistress, cough, sputum were common,and the fever and dyspnea were more commonin the worsen-treatment group than in the better-treatment group, there wassignificant difference(P﹤0.05).3．Imaging Findings In the two group,usually a variety of signs exist at thesame patient. The signs of nodule, multiple patchy and consolidation were common inthe two groups. And the consolidation in the worsen-group group was more commonthan in the better-treatment group, there was significant difference(P﹤0.05).4．Pathogens Bacterium The fungus was the most common in the two groups,and fungus with bacterium in the worsen-treatment group was more common than inthe better-treatment group, there was significant difference(P﹤0.05).5．WBC NEU Before the treatment,on the third day of treatment and on theseventh day of treatment, The level of WBC, NEU in the better-treatment group werehigher than in the worsen-treatment group, there were significant differences(P﹤0.05).But in the every group, before the treatment, on the third day of treatment andon the seventh day of treatment, the level of WBC, NEU have no significantdifference(P﹥0.05).6．CRP Before the treatment,on the third day of treatment and on the seventhday of treatment, The level of CRP in the better-treatment group was lower than in theworsen-treatment group,there were significant difference(P﹤0.05).And in thebetter-treatment group, before the treatment, on the third day of treatment and on theseventh day of treatment, the level of CRP has significant difference(P﹤0.05).7．PCT Before the treatment, on the third day of treatment and on the seventhday of treatment, The level of PCT in the worsen-treatment group were higher than inthe better-treatment group, there was significant difference(P﹤0.05).And in theworsen-treatment group, before the treatment, on the third day of treatment and on theseventh day of treatment, the level of PCT has significant difference(P﹤0.05). Conclusions1．There are many clinical characteristics in the patients with invasive pulmonaryfungal infection related to hematologic malignanices, the sysmptom of fever,chestdistress,cough,sputum are common. And the fever and dyspnea will be expected to beassociated with poor outcome.2．In the the patients with invasive pulmonary fungal infection related tohematologic malignanices, the signs of nodule,multiple patchy and consolidation arecommon.3．The level of WBC, NEU and CRP,PCT can evaluate the severity andprognosis of the disease.4．The PCT is higher when the patients with invasive pulmonary fungal infectionrelated to hematologic malignanices related to the infection of bacterium.