肝衰竭合并曲霉菌感染的临床特征分析  

The clinical characteristics of hepatic failure with aspergillosis

作　　者：苏海滨[1] 王慧芬[1] 闫涛[1] 林芳[1] 赵鸿[1] 李雷[1] 牟劲松[1] 李晨[1] 许海苗[1] 

机构地区：[1]解放军第三○二医院肝衰竭治疗研究中心,北京100039

出　　处：《中华肝脏病杂志》2010年第7期520-522,共3页Chinese Journal of Hepatology

基　　金：军队＂十一五＂中医药研发推广专项重大临床攻关项目（2006231001）

摘　　要：目的 了解肝衰竭合并曲霉菌感染的临床特征.方法 收集我院1985年1月-2006年6月所有合并真菌感染的肝衰竭患者507例,以合并曲霉菌感染的肝衰竭患者104例为主要分析对象.两组间数据的比较用配对t检验,率的比较用χ2检验. 结果 507例肝衰竭合并真菌感染患者中,曲霉菌感染104例（20.5%）.抗真菌治疗的有效率和基础疾病的治愈好转率,曲霉菌感染患者分别为36.5%和26.0%,非曲霉菌感染患者分别为57.8%和36.7%,P=0.000和P=0.049.共分离出曲霉菌108株,烟曲霉菌最为多见,共53株（49.1%）,肺脏为曲霉菌主要感染部位90例次（63.8%）,感染后临床表现常不典型.在抗真菌治疗有效的患者,肝功能呈好转趋势. 结论肝衰竭合并曲霉菌感染的诊断、治疗困难.对于临床上怀疑有曲霉菌感染的肝衰竭患者,早期积极治疗有助于患者恢复.Objective To study the clinical characteristics of hepatic failure with aspergillosis. Methods The data of hepatic failure patients with fungal infection hospitalized in our hospital form January 1985 to June 2006 were collected. This research mainly focused on the clinical characteristics of the patients co-infected with aspergillosis. Results The occurrence of aspergillosis was 20.5% （104 cases） among 507 hepatic failure patients with fungal infection. Compared with other fungal infection in hepatic failure patients, the effective rate of antifungal therapy and the improvement rate of underlying disease were worse in patients with aspergilus infection （36.5% vs 57.8%, P = 0.000; 26.0% vs 36.7%, P = 0.049）. Aspergillus fumigatus was the most common species among 108 fungal species. The species next to Aspergillus fumigatus were Aspergillus niger and Aspergillus flavus. The mainly infected organ was lung and its clinical manifestation was atypical. Liver function could be improved with effective anti-fungus-therapy. Conclusions Diagnosis and treatment of aspergillosis is difficult in hepatic failure patients co-infected with aspergillosis. Early and effective antifungal therapy is helpful to the recovery of liver function in the hepatic failure patients suspected with aspergillosis co-infection.

关 键 词：肝功能衰竭 曲霉菌病 感染 

分 类 号：R519[医药卫生—内科学]