激素治疗哮喘患者医院真菌感染特征与对策的研究  

Nosocomial Fungal Infection of Asthma Treated by Hormone:Characteristics and Coutermeasures

作　　者：罗维贵[1] 揭志军[2] 许杰[1] 李健[2] 卢冬[1] 

机构地区：[1]广西右江民族医学院附属医院,广西百色533000 [2]上海第二医科大学附属新华医院,上海200092

出　　处：《中华医院感染学杂志》2004年第5期502-504,共3页Chinese Journal of Nosocomiology

摘　　要：目的　研究激素治疗哮喘患者发生医院真菌感染的危险因素、病原菌分类、临床特征和防治措施。方法　用前瞻性与回顾性剖析 5 1例激素治疗哮喘患者医院真菌感染的观察指标和临床资料。结果　医院真菌感染除与不合理使用激素和抗生素外 ,尚与年龄、体重、血糖、白 -球蛋白、白细胞减少、细胞毒性药物、介入治疗、通气治疗、氧疗时间、住院日等相关 ;肺部真菌感染率为 8.6 9% ;病原菌分类前 3位为白色念珠菌占 37.2 5 %、热带念珠菌为 19.6 1%、近平滑念珠菌 15 .6 9% ;临床表现多样性 ,以及氟康唑、大蒜素、两性霉素 B、5 -氟胞嘧啶、制霉菌素的敏感率分别为 92 .11%和 91.17%、87.0 6 %、81.4 8%、76 .6 6 %、 6 4 .0 0 %。结论　要减少真菌感染率 ,重视激素和抗生素的合理应用是关键 ,祛除诱因与清除高危因素是防范手段 ,感染后的治疗措施宜按药敏选药 ,口服左旋咪唑或大蒜素能降低感染发病率。OBJECTIVE To study the risk factor,fungi classification,clinical feature,prevention and cure measures of hormones treatment on occurrence of nosocomial fungal infection in patients with asthma. METHODS A total of 51 cases were prospectively and retrospectively observed. RESULTS The nosocomial fungal infection was related not only to the irrational usage of hormones and antibiotics but also the age,body weight,blood sugar,globulin,leucocytopenia,cytotoxicity of drug,interventional therapy,ventilation therapy,oxygen therapy time,and hospitalizing time;the infection rate of lung fungal infection was 8.69%;the main fungi were Candida albicans (37.25%),C. tropicalis (19.61%),C. parapsilosis (15.69%);the sensitive rate of fluconazole,garlicin,amphotericin B,5-FC,and nystatin were 91.17%,87.06%,81.48%,76.66% and 64.00%. CONCLUSIONS To decrease the fungal infection rate,reasonable application of hormones and antibiotics was important. Removing the evoked cause and the high risks were the prevention measures.Taking orally levamisole or garlicin could decrease infection rate.

关 键 词：哮喘 激素 真菌感染 防治 

分 类 号：R562.25[医药卫生—呼吸系统]