老年慢性阻塞性肺疾病合并下呼吸道真菌感染的临床特点分析

发布时间：2018-07-07 14:01

本文选题：慢性阻塞性肺疾病 + 真菌感染　；参考：《中华医院感染学杂志》2014年06期

【摘要】：目的分析老年慢性阻塞性肺疾病(COPD)患者发生下呼吸道真菌感染的临床特点、病情严重程度及其与住院期间死亡危险性关系。方法选择2011年1月-2013年1月收治79例年龄≥65岁的COPD住院患者,36例COPD发生下呼吸道真菌感染患者为感染组,43例未发生下呼吸道真菌感染患者为对照组,比较两组基础资料、实验室检查、抗菌药物及激素使用、呼吸机辅助通气、住院时间及转归情况;所有数据均使用SPSS18.0软件进行统计分析。结果老年COPD住院患者长期卧床及各种侵入性操作吸痰、机械通气、留置尿管的分布率,感染组分别为47.22%、52.78%、16.13%、41.67%;对照组分别为18.60%、18.60%、2.32%、18.60%,感染组明显高于对照组,差异有统计学意义(P0.05);感染组pH值、血红蛋白、血清白蛋白均低于对照组,差异有统计学意义(P0.05),二氧化碳分压、糖化血红蛋白、降钙素原、血沉、超敏C-反应蛋白均高于对照组,差异有统计学意义(P0.05);感染组抗菌药物种类、激素与呼吸机辅助通气使用率均多于对照组;感染组住院时间明显长于对照组,并发症多于对照组,好转出院率略低于对照组。结论对老年COPD患者应早期诊断真菌感染,减少侵入性操作,积极控制感染,改善营养状态,改善预后。
[Abstract]:Objective to analyze the clinical characteristics, severity and mortality risk of lower respiratory tract fungal infection in elderly patients with chronic obstructive pulmonary disease (COPD). Methods from January 2011 to January 2013, a total of 79 COPD inpatients aged more than 65 years with COPD and 36 COPD patients with lower respiratory fungal infection were selected as the control group. 43 patients with no lower respiratory tract fungal infection were selected as the control group. The basic data of the two groups were compared. Laboratory examination, antibiotics and hormone use, ventilator assisted ventilation, hospital stay and outcome; all data were analyzed by SPSS 18.0 software. Results the distribution rates of long-term bed rest and various invasive operations, suction, mechanical ventilation and indwelling urethral catheter in the elderly COPD inpatients were 47.2222, 52.78 and 16.1313 respectively in the infection group and 18.60% in the control group, respectively. The infection group was significantly higher than that in the control group, which was significantly higher than that in the control group, and was significantly higher in the infection group than in the control group. The pH value, hemoglobin, serum albumin in the infection group were lower than those in the control group (P0.05), the difference was statistically significant (P0.05), the difference was statistically significant (P0.05), the levels of glycosylated hemoglobin, procalcitonin, erythrocyte sedimentation rate and hypersensitive C-reactive protein were higher than those in the control group. The difference was statistically significant (P0.05); the use rate of antibiotics, hormone and ventilator in infection group was higher than that in control group; the hospitalization time of infection group was longer than that of control group, the complication was more than that of control group, and the rate of improved discharge was slightly lower than that of control group. Conclusion in elderly patients with COPD, fungal infection should be diagnosed early, invasive operation should be reduced, infection should be controlled actively, nutritional status should be improved and prognosis should be improved.
【作者单位】：首都医科大学附属北京同仁医院干部医疗科;首都医科大学附属北京友谊医院综合内科;
【基金】：北京市保健科研基金项目(京13-08) 北京市委重大基金资助项目(D121100004912001)
【分类号】：R563.9

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