类风湿性关节炎患者肺部真菌感染的危险因素分析

发布时间：2018-04-10 00:22

本文选题：类风湿性关节炎　切入点：肺部真菌感染　出处：《中华医院感染学杂志》2014年06期

【摘要】：目的观察类风湿性关节炎患者肺部真菌感染的危险因素及相应的诊治措施,以预防真菌感染。方法选择2008年3月-2013年5月就诊的62例类风湿性关节炎患者,调查分析患者年龄、性别、平均病程、糖皮质激素应用与否、是否合并肺间质纤维化、长期抗菌药物联合应用及实验室的检查指标等,观察引起肺部真菌感染的危险因素。结果 62例类风湿性关节炎患者出现肺部真菌感染28例,感染率为45.16%,检出的真菌中曲霉菌属19株占67.86%,白色假丝酵母菌5株占17.86%,新型隐球酵母菌1株占3.57%,其他真菌3株占10.71%;研究结果表明,50岁、女性患者、病程较长、糖皮质激素的长期足量应用、合并肺间质纤维化及长期的抗菌药物联合应用均是类风湿性关节炎患者发生肺部真菌感染的危险因素,差异有统计学意义(P0.05);实验室的检查指标白细胞计数、血沉和C-反应蛋白异常与类风湿性关节炎患者发生肺部真菌感染无明显相关,差异无统计学意义。结论针对研究结果可以指导相应的预防诊治方案,对于类风湿性关节炎患者要合理使用糖皮质激素,适时停用抗菌药物,避免患者出现肺部真菌感染,尽快使患者康复。
[Abstract]:Objective to observe the risk factors of pulmonary fungal infection in patients with rheumatoid arthritis and to prevent fungal infection.Methods Sixty-two patients with rheumatoid arthritis from March 2008 to May 2013 were investigated and analyzed for age, sex, mean course of disease, use of glucocorticoid, and pulmonary interstitial fibrosis.The risk factors of pulmonary fungal infection were observed by long-term combined use of antimicrobial agents and laboratory examination.Results there were 28 cases of pulmonary fungal infection in 62 cases of rheumatoid arthritis.The infection rate was 45.16. 19 strains of Aspergillus accounted for 67.86%, 5 strains of Candida albicans accounted for 17.86 strains, 1 strain of new Cryptococcus cerevisiae accounted for 3.57% and 3 strains of other fungi accounted for 10.71%.Long-term adequate use of glucocorticoids, combined with pulmonary interstitial fibrosis and long-term antibiotic use were risk factors for pulmonary fungal infection in patients with rheumatoid arthritis.The difference was statistically significant (P 0.05), and there was no significant correlation between the white blood cell count, erythrocyte sedimentation rate and C-reactive protein abnormality and pulmonary fungal infection in patients with rheumatoid arthritis.Conclusion according to the results of the study, we should use glucocorticoid rationally, stop antibiotics timely, avoid pulmonary fungal infection, and make the patients recover as soon as possible in order to guide the prevention and treatment of rheumatoid arthritis.
【作者单位】：武警上海总队医院风湿科;武警上海总队医院呼吸科;
【基金】：国家自然科学基金资助项目(81101767)
【分类号】：R519;R593.22

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