慢性阻塞性肺疾病患者合并肺部真菌感染的危险因素分析及预防  

Risk factors analysis and prevention of pulmonary fungal infection in patients with chronic obstructive pulmonary disease

作　　者：邵赛萍 陈松宽[2] 

机构地区：[1]浙江省兰溪市人民医院内科,浙江兰溪321100 [2]浙江省立同德医院放射科,浙江杭州310012

出　　处：《中国现代医生》2016年第8期34-36,共3页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2013KYA036)

摘　　要：目的探讨慢性阻塞性肺疾病患者合并肺部真菌感染的危险因素分析及预防对策。方法选取2010年1月～2015年1月我院住院治疗的100例COPD患者的临床资料进行分析,其中50例COPD患者继发肺部真菌感染,其余50例无真菌感染者为对照组。对比分析两组患者的以下各方面因素：年龄（≥65岁,〈65岁）、性别（男、女）、吸烟史、合并基础疾病（糖尿病、呼吸衰竭、右心衰、肝肾功能不全）、低蛋白血症、机械通气、抗生素使用时间（〉14 d、≤14 d）、长期使用糖皮质激素、ApacheⅡ评分、抗生素使用时间。结果两组患者在性别、吸烟史及Apache II评分方面比较,差异无统计学意义（P〉0.05）;感染组患者与无感染组在年龄、合并糖尿病、呼吸衰竭及低蛋白血症、机械通气、长期使用抗生素及糖皮质激素方面存在显著性差异（P〈0.05）;年龄≥65岁（OR=3.231）、合并糖尿病（OR=3.672）、呼吸衰竭（OR=4.754）及低蛋白血症（OR=3.231）、进行机械通气（OR=2.982）及长时间使用抗生素（OR=2.836）及糖皮质激素（OR=2.518）为COPD合并肺部真菌感染的危险因素（P〈0.05）。结论慢性阻塞性肺疾病患者合并肺部真菌感染的危险因素较多,有针对性的采取干预措施,有利于促进疾病的治疗和康复。Objective To investigate the risk factors of chronic obstructive pulmonary disease complicated with pulmonary fungal infection. Methods The clinical data of 100 patients with COPD in our hospital from January 2010 to January 2015 were analyzed, including 50 cases of COPD patients with secondary pulmonary fungal infection, and the other 50 cases without fungal infection as the control group, risk factors of chronic obstructive pulmonary disease complicated with pulmonary fungal infection were analyzed. Comparative analysis of two groups of patients with the following factors： age（≥65, 〈65 years old）, sex（male and female）, smoking history, with underlying diseases（diabetes, respiratory failure, right heart failure, liver and kidney function）, low protein hyperlipidemia, mechanical ventilation, antibiotics use time（〉14 days, equal to or less than 14 days）, long-term use of sugar cortical hormone, ApacheⅡ score, antibiotics usage time. Results The two groups were compared in terms of gender, smoking history, and the ApacheⅡ score, the difference was not significant（P〉0.05）; there were significant differences in age, diabetes, respiratory failure and hypoproteinemia, mechanical ventilation, long-term use of antibiotics and glucocorticoid between infection group and non infection group（P〈0.05）, terms of age ≥65 years old（OR =3.231）, diabetes（OR =3.672）, respiratory failure（OR =4.754）and lower protein hypoproteinemia（OR=3.231）, with mechanical ventilation（OR=2.982） and the use of antibiotics（OR=2.836） and corticosteroids（OR=2.518） with long time were risk factors of pulmonary fungal infection in COPD mechanical ventilation（P〈0.05）. Conclusion The risks of chronic obstructive pulmonary disease patients with pulmonary fungal infection factors are more, have targeted intervention measures that is conducive to treatment and rehabilitation of disease.

关 键 词：慢性阻塞性肺疾病 肺部真菌感染 危险因素 预防 

分 类 号：R563.9[医药卫生—呼吸系统]