慢性阻塞性肺疾病急性加重期患者并发肺部曲霉菌感染的临床特征及其影响因素  

Clinical characteristics of pulmonary Aspergillus infection in patients with acute exacerbation of chronic obstructive pulmonary disease and their influencing factors

作　　者：蒋婷 谭锚 喻磊 付义 兰发勇 JIANG Ting;TAN Mao;YU Lei;FU Yi;LAN Fa-yong(Xindu District Third People's Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市新都区第三人民医院呼吸内科,四川成都610000

出　　处：《中华医院感染学杂志》2024年第4期494-497,共4页Chinese Journal of Nosocomiology

基　　金：四川省卫生健康委员会基金资助项目(2020151)。

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者并发肺部曲霉菌感染的临床特征及其影响因素.方法选取成都市新都区第三人民医院2021年2月—2022年12月收治的AECOPD患者110例为研究对象,根据患者是否并发肺部曲霉菌感染分为并发肺部曲霉菌感染组(n=52)和未并发肺部曲霉菌感染组(n=58);统计并发肺部曲霉菌感染现况和AECOPD患者肺部曲霉菌感染临床及CT表现,分析AECOPD患者肺部曲霉菌感染的影响因素.结果110例AECOPD患者中并发肺部曲霉菌感染为52例,发生率为47.27%,临床表现主要为呼吸困难、乏力/食欲减退及胸痛,CT影像学表现主要为晕轮征、斑片渗出影;吸烟史、机械通气操作、糖皮质激素使用时间、糖尿病、血清白蛋白是AECOPD患者肺部曲霉菌感染的影响因素(OR=2.804,2.578,2.228,2.136,2.208,P均<0.05).结论AECOPD患者肺部曲霉菌感染临床表现主要为呼吸困难、乏力/食欲减退及胸痛,CT影像学表现主要为晕轮征、斑片渗出影;临床可根据影响因素给予患者针对性治疗及干预措施,以降低AECOPD患者肺部曲霉菌感染的发生风险.OBJECTIVE To investigate the clinical characteristics of pulmonary Aspergillus infection in patients with AECOPD and their influencing factors.METHODS Totally 110 patients with AECOPD admitted to the Third Peo-ple's Hospital of Xindu District of Chengdu from Feb.2021 to Dec.2022 were selected as the study subjects,and they were divided into the group of concurrent pulmonary Aspergillus infection(n=52)and the group of non-con-current pulmonary Aspergillus infection(n=58)according to whether the patients were concurrent with pulmona-ry Aspergillus infection or not.The current status of concurrent pulmonary Aspergillus infection and the clinical and CT manifestations of pulmonary Aspergillus infection in patients with AECOPD were obtained,and the influ-encing factors of pulmonary Aspergillus infection in patients with AECOPD were analyzed.RESULTS Pulmonary Aspergillus infection occurred in 52 of 110 patients with AECOPD,with an incidence rate of 47.27%,and the clinical manifestations were mainly dyspnea,fatigue/loss of appetite and chest pain,and the CT imaging findings were mainly halo sign and spot exudation.Smoking history,mechanical ventilation operation,glucocorticoid use time,diabetes mellitus,serum albumin were independent influencing factors for pulmonary Aspergillus infection in patients with AECOPD(OR=2.804,2.578,2.228,2.136,2.208,respectively;all P<0.05).CONCLUSION The clinical manifestations of pulmonary Aspergillus infection in AECOPD patients were mainly dyspnea,fatigue/loss of appetite and chest pain,and the CT imaging findings were mainly halo sign and spot exu-dation.Clinical targeted treatments and interventions should be given according to the influencing factors,so as to reduce the risk of pulmonary Aspergillus infection in patients with AECOPD.

关 键 词：慢性阻塞性肺疾病急性加重期 肺部曲霉菌感染 临床特征 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]