慢性阻塞性肺疾病老年患者并发肺部真菌感染的危险因素  

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

作　　者：何薇[1] 

机构地区：[1]绍兴市人民医院,浙江大学绍兴医院呼吸内科,浙江绍兴312000

出　　处：《中国生化药物杂志》2016年第4期176-178,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的分析探讨慢性阻塞性肺病（chronic obstruct pulmonary diseases,COPD）合并肺部真菌感染患者发病的危险因素。方法研究对象选取2011年9月~2014年9月来绍兴市人民医院呼吸内科就诊的COPD合并肺部真菌感染的48例患者（观察组）及同期入院就诊的48例未合并肺部真菌感染的COPD患者（对照组）,对2组患者的临床资料回顾分析。观察比较2组患者年龄、性别、抗生素和激素使用情况、血清白蛋白水平、机械通气及合并症（糖尿病、呼吸衰竭、心衰）等情况。结果观察组患者痰培养结果显示,单纯白色念珠菌感染17例（35.42%）,光滑假丝酵母菌4例（8.33%）、热带假丝酵母菌3例（6.25%）、曲霉菌22例（45.83%）及合并感染2例（4.17%）。2组患者的年龄及性别比较差异无统计学意义,观察组患者血清白蛋白水平明显低于对照组,合并糖尿病、Ⅱ型呼吸衰竭以及右心衰的患者明显优于对照组,观察组患者抗生素使用时间、激素使用率及机械通气率明显优于对照组,比较差异均有统计学意义（P〈0.05）。多因素Logistic回归分析发现,低血清白蛋白、长期抗生素使用、机械通气、合并糖尿病及合并Ⅱ型呼吸衰竭是COPD患者合并肺部真菌感染的独立危险因素。结论 COPD合并肺部真菌感染患者的发病危险因素较多,以低血清白蛋白水平、长期抗生素使用、机械通气、合并糖尿病及合并Ⅱ型呼吸衰竭为主要独立危险因素。临床上应采取积极的防治措施,继而减少真菌感染的可能。Objective To investigate the risk factors of pulmonary fungal infection in patients with chronic obstructive pulmonary disease（ COPD）. Methods 48 cases of patients with COPD complicated with pulmonary fungal infection in September 2011 to September 2014 in respiratory department of Shaoxing People＇s hospital（ observation group） and 48 cases without pulmonary fungal infection of COPD of patients at the same period（ control group） were selected,clinical data of two groups were retrospectively analyzed. The age,sex,antibiotics and hormone usage,serum albumin,mechanical ventilation and complications（ diabetes,respiratory failure,heart failure） were compared between two groups. Results The results of sputum culture in the observation group showed that the infection rate of Candida albicans infection was 17（ 35. 42%）,Candida glabrata was 4（ 8. 33%）,Candida tropicalis 3（ 6. 25%）,Aspergillosis was 22（ 45. 83%） and concurrent infection was 2（ 4. 17%）. The age and sex of the patients between two groups had no statistically significant difference,the levels of serum albumin in the observation group was significantly lower than that of the control group,combined with diabetes,type II respiratory failure and right heart failure of the patients were significantly higher than that of the control group（ all P〈0. 05）. The antibiotics use time,hormone use rate and rate of mechanical ventilation in the observation group were significantly better than that of control group,the differences were statistically significant（ all P〈0. 05）. The multivariate logistic regression analysis showed that,low serum albumin,long-term use of antibiotics,mechanical ventilation,combined with diabetes and type II respiratory failure were the independent risk factors of nosocomial pulmonary fungal infection in patients with COPD. Conclusion There are many risk factors in patients with COPD complicated with pulmonary fungal infection,low serum albumin levels,long-term use of antibiotics,mechanical ventila

关 键 词：慢性阻塞性肺病 肺部 真菌感染 危险因素 老年 

分 类 号：R563[医药卫生—呼吸系统]