肺结核合并真菌感染58例临床观察

目的通过对58例肺结核合并真菌感染的认识与处理。方法从2004年1月～2006年12月三年间收治的肺结核病例中58例合并真菌感染的资料并进行回顾分析。结果58例真菌感染中自色念珠菌20例（34．5％）；热带念珠菌10例（17．2％）；光滑念珠菌8例（13．8％）；克柔念珠菌7例（12．1％）；曲霉菌12例（20．7％），季也蒙念珠菌1例（1．7％）。感染的诱发因素多与应用抗生素和激素有关。结论临床医师应加强对结核病合并真菌感染的警惕性；合理应用抗结核药物，加强抗生素及肾上腺皮质激素的规范应用，以减少真菌感染及耐药的发生，有利于结核病控制及减少死亡。

Pulmonary tuberculosis complicated with fungi infection:a clinical analysis on 58 cases

Objective To study the clinical features of pulmonary tuberculosis complicated with fungi infection, and to improve the recognition and treatment of the coexistence of these two diseases. Methods 58 cases of pulmonary tuberculosis complicated with fungi infection in our hospital from January of 2004 to December of 2006 were investigated retrospectively. Results The distribution of fungi in 58 cases were Candida albicans （34.5 % ）, C. tmpicalis （ 17.2% ）, glabrata （ 13.8 % ） and candida kmsei （ 12. 1% ）, A. fumigatus （20. 7% ）, C. gnilliermondii （ 1.7% ）. Long history of tuberculosis, elder patients, the extensive range of lesions and many cavities in lungs were risk factors, and their diagnosis depended on the examination of pathogenic organizes. Conclusion It is common that fungal infection occurred in pulmonary tuberculosis cases. Standardized application of antibiotic and hormone should be strengthened to reduce the rate of fungal infection and their resistance rates ,which will control the tuberculosis and reduce the death rate.