慢性阻塞性肺疾病急性加重期患者合并侵袭性肺曲霉菌病的危险因素分析  

Analysis of Risk Factors for Invasive Pulmonary Aspergillosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：谢凌燕 XIE Lingyan(Department of Respiratory and Critical Care Medicine,Longyan First Hospital,Longyan,Fujian,364000,China)

机构地区：[1]龙岩市第一医院呼吸与危重症医学科,福建龙岩364000

出　　处：《中外医疗》2024年第34期53-56,共4页China & Foreign Medical Treatment

摘　　要：目的分析慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者合并侵袭性肺曲霉菌病(invasive pulmonary aspergillosis,IPA)的危险因素。方法回顾性选取2022年10月—2023年11月龙岩市第一医院收治的209例AECOPD患者的临床资料,统计合并IPA情况,并采用单因素分析与多因素二元Logistic回归明确IPA发生的危险因素。结果209例AECOPD患者中33例合并IPA,发生率为15.79%(33/209);两组患者在机械通气史、糖皮质激素使用时间、吸烟史、血清白蛋白水平、合并糖尿病方面对比,差异均有统计学意义(P均<0.05)。多因素二元Logistic回归分析显示,有机械通气史(OR=2.509,95%CI:2.011~3.131)、糖皮质激素使用时间≥7 d(OR=3.795,95%CI:3.012~4.619)、有吸烟史(OR=6.582,95%CI:5.722~7.038)、血清白蛋白水平<30 g/L(OR=2.337,95%CI:1.976~2.958)、合并糖尿病(OR=5.426,95%CI:4.867~6.112)均是影响AECOPD患者合并IPA的独立危险因素(P均<0.05)。结论AECOPD患者合并IPA,与机械通气史、糖皮质激素使用时间≥7 d、有吸烟史、合并糖尿病、血清白蛋白水平<30 g/L存在密切关系。Objective To analyze the risk factors of invasive pulmonary aspergillosis(IPA)in patients with acute exac-erbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 209 patients with AECOPD admitted to Longyan First Hospital from October 2022 to November 2023 were retrospectively selected.The combined IPA was counted,and the risk factors of IPA were determined by univariate analysis and multivariate binary Logistic regression analysis.Results Of the 209 patients with AECOPD,33 had IPA,with an incidence of 15.79%(33/209),there were significant differences between the two groups in the history of mechanical ventilation,glucocorticoid use time,smoking history,serum albumin level,and diabetes mellitus(all P<0.05).Multivariate binary Logistic regres-sion analysis showed that,the history of mechanical ventilation(OR=2.509,95%CI:2.011-3.131),glucocorticoid use time≥7 d(OR=3.795,95%CI:3.012-4.619),smoking history(OR=6.582,95%CI:5.722-7.038),serum albumin level<30 g/L(OR=2.337,95%CI:1.976-2.958),and diabetes mellitus(OR=5.426,95%CI:4.867-6.112)were inde-pendent risk factors for IPA in AECOPD patients(all P<0.05).Conclusion AECOPD patients with IPA were closely related to the history of mechanical ventilation,glucocorticoid use time≥7 d,smoking history,diabetes mellitus,and serum albumin level<30 g/L.

关 键 词：慢性阻塞性肺疾病急性加重期 侵袭性肺曲霉菌 危险因素 

分 类 号：R59[医药卫生—内科学]