COPD患者痰真菌培养阳性的相关因素

目的探讨COPD患者痰真菌培养阳性的危险因素。方法收集2005年1月至2007年12月期间于上海市第一人民医院、中山医院及华东医院呼吸科住院的COPD急性加重期患者的病史资料进行回顾性分析。结果共收集到78例患者,以痰真菌培养结果分组,痰真菌培养阳性组与阴性组在性别、年龄、糖尿病史、吸烟史、雾化吸入史、累计口服皮质激素及皮质激素吸入史方面差异无统计学意义(P0.05),在抗生素使用种类、使用时间、累计静脉使用皮质激素剂量和使用时间等方面差异显著(P0.01)。多因素分析提示抗生素和皮质激素使用时间长及皮质激素静脉使用剂量大是痰真菌培养阳性的危险因素(P0.05)。结论长期大量皮质激素的使用,长期应用多种广谱抗生素是COPD患者下呼吸道真菌定植的危险因素。

Risk Factors of Positive Yield in Sputum Fungal Culture in Patients with Chronic Obstructive Pulmonary Disease

Objective To investigate the risk factors of positive yield in sputum fungal culture in patients with chronic obstructive pulmonary disease（COPD）.Methods The patients with COPD who hospitalized in the respiratory departments of Shanghai First People＇s Hospital,Zhongshan Hospital,and Huadong Hospital from January 2005 to December 2007 were analyzed retrospectively.Results The 78 patients were grouped according to the results of sputum fungal culture.There were no significant differences in sex,age,history of smoking,diabetes,atomization inhalation,and the accumulated doses of oral corticosteroids between the positive group and the negative group（P0.05）.However,the differences in species of antibiotics,duration of antibiotic therapy,and accumulated doses of intravenous corticosteroids were significant（P0.01）.The logistic analysis showed that prolonged high-dose of corticosteroids and multiple broad-spectrum antibiotics were risk factors of the positive yield of sputum fungal culture（P0.05）.Conclusion Prolonged high-dose of corticosteroids and multiple broad-spectrum antibiotics are risk factors of fungal colonization in lower respiratory tract of COPD patients.