老年慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者肺部真菌感染危险因素分析  

Analysis of risk factors for pulmonary fungal infection in patients with AECOPD complicated with typeⅡ respiratory failure

作　　者：李俊兰[1] 于树云[1] 

机构地区：[1]天津医科大学第二医院呼吸科,300211

出　　处：《淮海医药》2017年第1期8-10,共3页Journal of Huaihai Medicine

摘　　要：目的:分析慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者发生肺部真菌感染的危险因素。方法:收集天津医科大学第二医院收治的274例老年AECOPD合并Ⅱ型呼吸衰竭患者的临床资料,按有无肺部真菌感染分为YES组(n=55例)与NO组(n=219例),将可能导致患者发生肺部真菌感染的危险因素进行量化赋值,先后进行单因素与多因素logistic回归分析。结果:多因素logistic回归分析发现,病程(OR=10.414)、抗生素使用时间(OR=4.593)、糖皮质激素(OR=5.227)、低蛋白血症(OR=4.426)可能是AECOPD合并Ⅱ型呼吸衰竭患者发生肺部真菌感染的独立危险因素。结论:临床对病程长、长时间使用糖皮质激素及抗生素的AECOPD合并Ⅱ型呼吸衰竭患者,应进一步提高其发生肺部真菌感染的警惕。Objective：To analyze the risk factors of acute exacerbation of chronic obstructive pulmonary disease （ AECOPD ） with type Ⅱ respiratory failure in patients with pulmonary fungal infections. Methods： Clinical data of 274 aged AECOPD patients with type Ⅱ respiratory failure were collected and divided, according to the presence or absence of pulmonary fungal infection, into a YES group （n = 55） and a NO group （n = 219）. Risk factors leading to pulmonary fungal infection were quantitatively assigned and univariate and multivariate logistic regression analysis was conducted. Results：Multivariate logistic regression analysis showed that disease duration （ OR = 10. 414 ） , antibiotic use time （ OR = 4. 593 ） , corticosteroids （ OR = 5. 227 ） , and hypoproteinemia （ OR = 4.426 ） could be independent risk factors. Conclusion：It should be closely watched that for those AECOPD patients with type Ⅱ respiratory failure, long disease duration and prolonged use of corticosteroids and antibiotics may lead to the development of pulmonary fungal infections.

关 键 词：肺疾病 慢性阻塞性 呼吸衰竭 肺部感染 真菌 危险因素 

分 类 号：R563.8[医药卫生—呼吸系统] R563.9[医药卫生—内科学]