真菌性肠炎的临床特征、危险因素及治疗干预措施探究  

Clinical characteristics,risk factors and treatment intervention of fungal enteritis

作　　者：王荣 姬瑞[1] WANG Rong;JI Rui(The First Clinical College of Medicine,Lanzhou University,Lanzhou 730000,China;Department of Gastroenterology,The Second People's Hospital of Tianshui,Tianshui 741020,China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]天水市第二人民医院消化科,天水741020

出　　处：《中国真菌学杂志》2024年第6期591-595,共5页Chinese Journal of Mycology

基　　金：兰州市人才创新创业项目(2019-RC-33);兰州大学医学科研创新能力提升项目(定向探索项目)(2022-184)。

摘　　要：目的探索消化内科住院患者患真菌性肠炎的临床特征、危险因素及治疗干预措施。方法选取2018年3月—2023年8月于我科住院期间确诊真菌性肠炎的82例患者为研究对象,选取同时期住院的其他患者82例作为对照组。收集入组患者临床资料,对其进行logistic回归分析,同时对真菌性肠炎患者的治疗措施进行评价。结果82例真菌性肠炎患者的标本中共分离培养出病原菌89株,其中最常见的为白念珠菌,占比为79.78%;logistic回归分析显示,年龄、糖尿病史、慢性肠炎、长时间使用免疫抑制剂、激素和抗生素等均为消化内科住院患者患真菌性肠炎的独立危险因素(均P<0.05),经氟康唑口服治疗研究组患者CD4^(+)、IgA水平及CD4^(+)/CD8^(+)值显著升高,CD8^(+)水平显著降低,无明显不良反应。结论消化内科住院患者患真菌性肠炎病原菌以白念珠菌为主。患者年龄、糖尿病史、慢性肠炎、长时间使用免疫抑制剂、糖皮质激素和抗生素等均是导致患者院内感染真菌性肠炎的危险因素,临床针对上述因素的患者可预防性给予氟康唑口服。Objective To explore the clinical characteristics,risk factors and treatment intervention of fungal enteritis in inpatients in the department of gastroenterology.Methods The clinical data of 82 patients with fungal enteritis diagnosed in our department from March 2018 to August 2023 were collected retrospectively,and 82 other patients in the same period were selected as the control group.The clinical data of the patients were collected and analyzed by logistic regression analysis.At the same time,the treatment measures of patients with fungal enteritis were evaluated.Results A total of 89 pathogenic fungi were isolated and cultured from 82 patients with fungal enteritis,of which the most common was Candida albicans,accounting for 79.78%.logistic regression analysis showed that age,history of diabetes,chronic enteritis,long-term use of immunosuppressants,hormones and antibiotics were independent risk factors for fungal enteritis in hospitalized gastroenterology patients(all P<0.05).Oral treatment with fluconazole significantly increased the levels of CD4^(+),IgA and CD4^(+)/CD8^(+)values in the study group.CD8^(+)levels were significantly reduced without significant side effects.Conclusion Candida albicans is the main cause of fungal enteritis in digestive inpatients.Patients'age,history of diabetes,chronic enteritis,long-term use of immunosuppressants,hormones and antibiotics are all risk factors for nosocomial fungal enteritis.Patients with these factors can be given fluconazole orally.

关 键 词：真菌性肠炎 临床特征 危险因素 治疗 

分 类 号：R446[医药卫生—诊断学]