COPD继发肺部真菌感染的临床特征及发病相关因素分析

发布时间：2018-03-08 14:33

本文选题：慢性阻塞性肺疾病　切入点：肺部真菌感染　出处：《中华医院感染学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的分析慢性阻塞性肺疾病(COPD)继发肺部真菌感染的临床特征及发病相关因素,为临床诊断治疗提供参考依据。方法选取2010年6月-2016年6月医院接诊的2 010例COPD患者为研究对象,回顾性分析COPD继发肺部真菌感染的临床特征,分析其发病相关因素;采用单因素及多因素logistic回归对COPD继发肺部真菌感染的易感因素进行分析。结果 2 010例COPD患者继发肺部真菌感染20例,感染率为1.0%;共检出真菌21株,以白念珠菌为主,13株占61.9%;COPD继发肺部真菌感染的临床症状以咳嗽、咳痰、发热等为主,与COPD患者比较未表现特异性;患者的年龄、住院时间、激素种类及疗程、抗菌药物种类及疗程和血浆白蛋白为COPD继发肺部真菌感染的相关因素(P0.05);多因素分析表明,抗菌药物和激素疗程越长、住院时间久、血浆白蛋白低于正常值、存在侵袭性诊疗操作是继发真菌感染的主要危险因素。结论避免过度和盲目广谱抗菌药物及激素的使用,不仅可以降低COPD继发肺部真菌感染的发病率,还可以提高治疗效率、防止病情恶化。
[Abstract]:Objective to analyze the clinical features and related factors of pulmonary fungal infection secondary to chronic obstructive pulmonary disease (COPD), and to provide reference for clinical diagnosis and treatment. The clinical features of pulmonary fungal infection secondary to COPD were analyzed retrospectively and the related factors were analyzed. The susceptible factors of pulmonary fungal infection secondary to COPD were analyzed by univariate and multivariate logistic regression. Results 20 cases of secondary pulmonary fungal infection were found in 2010 cases of COPD, the infection rate was 1.0%, 21 strains of fungi were detected. 13 strains of Candida albicans accounted for 61.9% of the clinical symptoms of pulmonary fungal infection, such as cough, expectoration, fever, etc. The type and course of antimicrobial agents and plasma albumin were the relative factors of pulmonary fungal infection secondary to COPD (P 0.05). Multivariate analysis showed that the longer the course of treatment of antibiotics and hormones, the longer the duration of hospitalization, the lower the level of plasma albumin. Conclusion avoiding excessive and blind use of broad-spectrum antibiotics and hormones can not only reduce the incidence of pulmonary fungal infection secondary to COPD, but also improve the therapeutic efficiency. Prevent the disease from getting worse.
【作者单位】：浙江省淳安县第一人民医院呼吸内科;浙江省人民医院呼吸内科;温州医科大学-基础医学院;
【基金】：浙江省医药卫生科技计划项目(2013YB171)
【分类号】：R563.9;R519

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