侵袭性肺部真菌感染危险因素分析

目的探讨分析医院住院病人侵袭性肺部真菌感染的危险因素。方法采用病例回顾性研究,系统阅读并分析120例病人肺部真菌感染的资料。对真菌感染组和非真菌感染组的临床特点进行比较,然后对有统计学意义的可能危险因素进行多因素Logistic回归分析,找出呼吸道真菌感染的主要危险因素。结果真菌感染组的平均住院时间、平均使用广谱抗生素时间均长于非真菌感染组;真菌感染组糖皮质激素、体内保留导管、有创机械通气使用率均高于非真菌感染组;真菌感染组恶性肿瘤、肺结核患病率均高于非真菌感染组;真菌感染组的白蛋白及血红蛋白水平均低于非真菌感染组。再经多因素Logistic回归分析显示,长期使用广谱抗生素、糖皮质激素、低蛋白血症、有创机械通气,恶性肿瘤,肺结核是真菌感染的独立危险因素。结论长期使用广谱抗生素、糖皮质激素、低蛋白血症、有创机械通气、恶性肿瘤、肺结核是真菌感染的独立危险因素。有效控制相关患病危险因素,可能是防治呼吸道真菌感染的关键。

Investigation of risk factors of 120 cases of invasive pulmonary fungal infections

Objective To study the risk factors of the invasive pulmonary fungal infections.Methods Using the method of the case-control study,reading and analyzing the information of pulmonary fungal infection.To compare the clinical features between the fungal infection group and non-fungal infection group, then there is the possibility of significant risk factors for multivariate Logistic regression analysis to identify the major risk factors of respiratory fungal infection.Results The average length of stay and the average time of using broad-spectrum antibiotics of fungal infection group were longer than those of nonfungal infection group;glucocorticoid hormones,the body retained catheters,invasive mechanical ventilation utilization rates of fungal infection group were higher than those of non-fungal infection group;malignant cancer,tuberculosis prevalence rates of fungal infection group are higher than those of non-fungal infection group;the albumin and hemoglobin of fungal infection were lower than the non-fungal infection group.And then by multivariate Logistic regression analysis showed that long-term use of broad-spectrum antibiotics,corticosteroids,hypoproteinemia,invasive mechanical ventilation,malignancy,tuberculosis,fungal infections are an independent risk factor.Conclusion Long-term use of broad-spectrum antibiotics,corticosteroids,hypoproteinemia,invasive mechanical ventilation,malignancy,tuberculosis,fungal infections are independent risk factors. Effective control of associated risk factors may be the key to prevention and treatment of respiratory tract fungal infection.