重度支气管哮喘患者下呼吸道真菌感染危险因素分析  

Analysis of risk factors for fungal infection of lower respiratory tract in patients with severe bronchial asthma

作　　者：毛伟[1] 崔恩海[1] 张炜[1] 

机构地区：[1]湖州市中心医院呼吸内科,浙江湖州313000

出　　处：《中华医院感染学杂志》2013年第23期5668-5670,共3页Chinese Journal of Nosocomiology

基　　金：湖州市科技局基金项目(2011YS03)

摘　　要：目的探讨支气管哮喘患者发生下呼吸道真菌感染的危险因素,并提出相应预防与控制对策,为控制呼吸科医院感染提供参考依据。方法对2009年7月-2011年7月收治的741例重度支气管哮喘患者临床资料进行回顾性分析,针对导致真菌感染发生的危险因素进行非条件logistic回归分析,找出重度支气管哮喘患者发生下呼吸道真菌感染的独立危险因素。结果 741例重度支气管哮喘患者中,发生呼吸道真菌感染76例,感染率为10.26%;经logistic回归分析后显示,年龄(β=0.751,OR=2.123)、抗菌药物应用(β=1.543,OR=4.665)、糖尿病史(β=1.677,OR=5.314)、激素应用(β=1.784,OR=5.934)、侵入性操作(β=1.595,OR=4.901)与重度支气管哮喘患者下呼吸道真菌感染的发生有密切关系,而高血压史、性别、氧疗与真菌感染无显著关联。结论在重度支气管哮喘患者中,对于有高龄、抗菌药物过度应用、糖尿病史、激素应用、侵入性操作和通气治疗等高危因素的患者应给予更密切观察及预防性处理,减少患者康复期医院感染的风险。OBJECTIVE To explore the risk factors of fungus infection of lower respiratory tract in patients with bronchial asthma and to put forward corresponding precautionary and control measures to provide the basis for controlling the respiratory nosocomial infection. METHODS A retrospective analysis was conducted on the clinical data of 741 patients with severe bronchial asthma from Jul. 2009 to Jul. 2011 in our department, and non-condi-tional logistic regression analysis was made on the risk factors leading to fungus infection in order to determine the independent ones leading to lower respiratory fungus infection. RESULTS The rate of lower respiratory tract fungal infection in patients with severe bronchial asthma was 10.26 % （76/741）. The logistic regression analysis showed that lower respiratory fungus infection had close relationship with age （β=0. 751, OR=2. 123）, the use of antimicrobial drugs （β=1. 543, OR = 4. 665）, diabetes （β=1. 677,OR = 5. 314）, hormones （β= 1. 784, OR= 5. 934） and invasive operation （β= 1. 595 ,OR=4. 901 ）, but was not significantly associated with high blood pres-sure, gender or oxygen therapy. CONCLUSION In the treatment of patients with severe bronchial asthma, closer observation and precautionary management should be given to those who are in advanced ages, overusing antimi crobial drugs, suffering from diabetes, taking hormones, invasive operation and ventilation therapy, so as to decrease the risk of onset of nosocomial infection during convalescence stage.

关 键 词：重度支气管哮喘 真菌感染 危险因素 回归分析 

分 类 号：R563.1[医药卫生—呼吸系统]