56例住院患者呼吸道真菌感染的临床分析

目的探讨呼吸道真菌感染的病因、发病机制、临床特点、常见菌种及有效的治疗药物。方法分析我院呼吸内科2002年1月～2006年8月56例住院患者呼吸道真菌感染的临床资料。结果56例呼吸道真菌感染患者中，上呼吸道感染14例（23．7％），下呼吸道感染45例（76．3％）。白色念珠菌36株（57．1％），非白色念珠菌18株（28．6％）。其主要诱因为不合理使用抗生素、长期使用激素、细胞毒类药物或其它免疫抑制剂、气管插管、气管切开及人工机械呼吸等。结论近年呼吸道真菌感染的发病率明显增加，以白色念珠菌最常见，其临床表现不典型，诊断主要靠胸部X线检查和深部痰培养。酮康唑和氟康唑治疗呼吸道真菌感染是安全有效的。

Clinical analysis of respiratory tract fungus infection

Objective To study the etiological factor, pathogenesis and clinical characteristic of respiratory tract fungus infection and to find effective therapy for common fungus infection. Method 56 cases of in-patients with respiratory tract fungus infection （ from January 2002 to August 2006） in the Respiratory Department of our hospital were analyzed. Results In 56 cases of respiratory tract fungus infection, 14 cases had upper respiratory tract fungus infection （23.7%） and 45 cases had lower respiratory tract fungus infection （76.3%）. Fungus culture found 36 strains of candida albicans （57.1%） and 18 strains of non - candida albicans （25.6%）. The main reasons of these fungus infection were abusing antibiotic, use of cytotoxic drugs, long term using glucocorticoid or other immune inhibitor and tracheal cannula, tracheal incision, and mechanical ventilation. Conclusion Morbidit of respiratory tract fungus infection is increasing in recent years and Candida albicans infection is the most common one often with no tipical clinic manifestation. The diagnosis relies on chest X ray and deep sputum culturing. Ketoconazole and Fluconazole are safe and effective for respiratory tract fungus infection.