慢性阻塞性肺病继发肺部真菌感染41例临床分析

目的探讨慢性阻塞性肺病(COPD)继发肺部真菌感染的常见原因及对策。方法对41例COPD伴真菌感染病例进行回顾性分析。结果应用抗生素3种以上者23例(56.10%),5种以上者10例(24.39%),29例同时使用了糖皮质激素(70.73%),痰培养的真菌谱为:白念珠菌24例(58.54%),热带念珠菌5例,克柔念珠菌2例,酵母样菌7例,曲霉菌3例。治愈26例(63.41%),好转6例(14.63%),无变化4例(9.76%),死亡5例,病死率12.19%。结论广谱抗生素和糖皮质激素的广泛应用是COPD继发肺部真菌感染的主要原因,及时诊断和治疗可提高其治愈率。

Clinical study of 41 patients of chronic obstructive pulmonary disease with secondary fungal infection

Objective To investigate the common reasons and measures of the chronic obstructive pulmonary disease (COPD) patients with secondary fungal infection.Methods To perform a retrospective study in 41 cases of COPD patients with secondary fungal infection.Results Twenty-three cases used 3 or more types of antibiotics (56.1%), 10 cases used 5(24.39%), and 29 cases used a combination of the steroid (70.73%). The results of the sputum fungi culture were as follows: 24 cases of Candida albicans, 5 cases of Candida tropicalis, 2 cases of candida krusei, 7 cases of yeast-like and 3 cases of Aspergillus. After the application of anti-fungal therapy, 26 (63.41%) were cured, 6 improved (14.63%), 4 had no effect (9.76%) and 5 cases were dead.Conclusion The main reason for COPD patients developing secondary fungal infection is the wide use of broad spectrum antibiotics and steroids, thus the early diagnose and treatment of the disease may improve the cure rate.