慢性阻塞性肺疾病患者肺部真菌感染危险因素研究

发布时间：2018-03-23 07:37

本文选题：慢性阻塞性肺疾病　切入点：真菌　出处：《中华医院感染学杂志》2014年13期 　论文类型：期刊论文

【摘要】：目的探讨慢性阻塞性肺疾病(COPD)患者继发医院肺部真菌感染及其危险因素,为临床治疗提供可靠的依据。方法回顾性分析2009年1月-2012年6月725例COPD患者的临床资料,对真菌感染患者危险因素进行分析;采用SPSS19.0软件对资料进行统计分析。结果 725例COPD患者中有56例发生肺部真菌感染感染率7.7%,共检出真菌83株,检出白色假丝酵母菌、热带假丝酵母菌、光滑假丝酵母菌、克柔假丝酵母菌、近平滑假丝酵母菌、毛霉菌属、曲霉菌属、葡萄牙假丝酵母菌,分别占60.24%、13.25%、6.02%、4.82%、7.23%、3.61%、2.41%、1.21%;真菌对制菌霉素、两性霉素B、伊曲康唑较敏感,对氟胞嘧啶、酮康唑及咪康唑的敏感性较差;低白蛋白血症、使用肾上腺糖皮质激素500mg、广谱抗菌药物使用时间14d、合并呼吸衰竭是COPD患者发生肺部真菌感染的独立危险因素(P0.05)。结论提高对COPD患者继发肺部真菌感染危险因素的认识,有针对性地采取防治措施,可以减少肺部真菌感染的发生。
[Abstract]:Objective to investigate the nosocomial pulmonary fungal infection and its risk factors in patients with chronic obstructive pulmonary disease (COPD) and to provide a reliable basis for clinical treatment. Methods the clinical data of 725 patients with COPD from January 2009 to June 2012 were retrospectively analyzed. The risk factors of fungal infection were analyzed and the data were analyzed by SPSS19.0 software. Results the infection rate of pulmonary fungal infection was 7.7 in 56 out of 725 patients with COPD. A total of 83 strains of fungi were detected and Candida albicans were detected. Candida tropicalis, Candida smoothing, Candida cerevisiae, Saccharomyces cerevisiae near smooth, Mucor, Aspergillus, Aspergillus, and Candida Portugal, respectively, accounted for 60.24% 13.25% 6.026.027.232.3.612.411.21; Fungi were sensitive to mycin, amphotericin B, itraconazole. The sensitivity to fluocytosine, ketoconazole and miconazole was poor. Using 500mg adrenal glucocorticoid and using broad-spectrum antimicrobial agents for 14 days, respiratory failure was an independent risk factor for pulmonary fungal infection in COPD patients (P 0.05). Conclusion the risk factors of secondary pulmonary fungal infection in patients with COPD should be improved. The prevention and cure measures can reduce the incidence of pulmonary fungal infection.
【作者单位】：瑞安市人民医院呼吸内科;
【基金】：温州市医药卫生科研基金资助项目(2006B055)
【分类号】：R563.9

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