COPD病人并发IPA危险因素分析

发布时间：2018-03-02 14:03

本文选题：慢性阻塞性肺疾病　切入点：侵袭性肺曲霉菌病　出处：《新疆医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：慢性阻塞性肺疾病(COPD)病人中并发侵袭性肺曲霉菌病(IPA)在逐年增多，但是鉴于IPA的临床症状不典型性，临床上很难早期诊断。本研究旨在分析COPD患者并发IPA的危险因素，以提高COPD患者早期诊断IPA可能。方法：通过病历系统选取新疆医科大学第一及第二附属医院2011年2月至2012年12月6例确诊和8例临床诊断的共14例COPD伴有IPA患者为病例组，及同年入院、性别相同、年龄及COPD病史基本一致的14例COPD患者作为对照组，于配比后进行病例对照研究，应用SPSS19.0软件单因素分析各项因素(包括宿主因素、临床症状、体征、实验室检查结果及诊疗经过)在COPD患者中发生IPA的作用。结果：通过单因素分析发现：吸烟史(2年，P=0.018)，血清白蛋白减低(35g/L，P=0.001)，既往住院天数(P=0.006)，转入ICU并伴有机械通气(P=0.013)四个因素是COPD病人发生IPA的主要危险因素。结论：COPD病人伴有长期吸烟史、血清白蛋白减低、既往住院天数较长、伴有入住ICU及机械通气史的患者较易发生IPA，鉴于临床上IPA发病率逐年升高及其很高的死亡率，发现COPD病人伴有以上几种危险因素时，，需提高警惕。
[Abstract]:Objective: the incidence of invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease (COPD) is increasing year by year, but in view of the atypical clinical symptoms of IPA, it is difficult to diagnose it early. This study was designed to analyze the risk factors of IPA in patients with COPD. In order to improve the possibility of early diagnosis of IPA in patients with COPD, 14 cases of COPD with IPA were selected from the first and second affiliated hospitals of Xinjiang Medical University from February 2011 to December 6th 2012 and 8 cases of clinical diagnosis from February 2011 to December 6th 2012. In the same year, 14 COPD patients with the same sex, same age and similar history of COPD were used as the control group. A case-control study was carried out after matching. The factors (including host factors, clinical symptoms, signs) were analyzed by SPSS19.0 software. Results: the role of IPA in COPD patients was found by univariate analysis. Results: smoking history was found by univariate analysis (2 years P0. 018, serum albumin decreased 35 g / L P0. 001, previous hospitalization days were P0. 006, ICU was transferred to ICU with mechanical ventilation P0. 013). Four factors are the main risk factors for developing IPA in COPD patients. Conclusion the patients with COPD have a long history of smoking. The patients with ICU and mechanical ventilation were more likely to develop IPA. In view of the increasing incidence of IPA and its high mortality rate in clinic, it was found that the patients with COPD were accompanied by the above risk factors. Vigilance is needed.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9

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