慢性阻塞性肺病急性加重期患者合并侵袭性肺曲霉菌感染的危险因素分析与临床特征

发布时间：2018-08-08 15:10

【摘要】：目的探讨慢性阻塞性肺病(COPD)急性加重期合并侵袭性肺曲霉菌感染的危险因素及临床特征,为临床预防及治疗提供参考。方法选取2012年6月-2016年1月于医院呼吸内科收治的COPD急性加重期合并肺部感染患者846例,合并侵袭性曲霉菌感染患者62例,分析感染因素及临床特征。结果 846例患者中合并侵袭性曲霉菌感染患者62例,感染率为7.33%;多因素logistics回归分析结果表明:合并糖尿病、近4周内出现过肺部感染、使用抗菌药物种类3种是COPD急性加重期合并侵袭性肺曲霉菌感染的独立危险因素(P0.05);观察侵袭性肺曲霉菌感染患者的临床表现可见表现为食欲减退及乏力;感染患者CT影像学表现主要为斑片渗出影、晕轮征。结论此类患者主要临床表现及CT表现未见明显特异性,临床医师还应及早诊断,具有预防意识,早期发现及诊治。
[Abstract]:Objective to investigate the risk factors and clinical features of acute exacerbation of chronic obstructive pulmonary disease (COPD) with invasive pulmonary aspergillus infection, and to provide reference for clinical prevention and treatment. Methods from June 2012 to January 2016, 846 patients with acute exacerbation of COPD complicated with pulmonary infection and 62 patients with invasive aspergillosis were selected. The infection factors and clinical characteristics were analyzed. Results 62 of 846 patients with invasive aspergillus infection had an infection rate of 7.33.The results of multivariate logistics regression analysis showed that pulmonary infection had occurred in the past 4 weeks. Three kinds of antimicrobial agents were the independent risk factors of invasive pulmonary aspergillus infection in acute exacerbation of COPD (P0.05), the clinical manifestations of invasive pulmonary aspergillus infection patients showed loss of appetite and fatigue. Ct findings of infected patients were mainly macular exudation and halo sign. Conclusion there is no obvious specificity in the main clinical manifestations and CT findings of this kind of patients. The clinicians should make early diagnosis, prevention consciousness, early detection, diagnosis and treatment.
【作者单位】：温岭市第一人民医院呼吸内科;
【基金】：浙江省医药卫生基金资助项目(2015KYB043)
【分类号】：R519;R563.9

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