慢性阻塞性肺疾病急性加重期肺部真菌感染分析

目的 探讨导致慢性阻塞性肺疾病(COPD)急性加重期肺部真菌感染的风险因素及针对性的治疗方法.方法 选取83例COPD急性加重期肺部真菌感染住院患者为观察对象(COPD真菌感染组),按照时间顺序逐月随机抽取住院的COPD急性加重无继发真菌感染的住院患者80例作为对照组,分析导致真菌感染的风险因素.结果 两组年龄、住ICU时间、抗生素使用时间、激素使用时间、白蛋白水平、机械通气人次、合并糖尿病、合并肺源性心脏病差异有统计学意义(P＜0.05)；非条件性的Logstic多因素分析,患者年龄、住ICU时间、抗生素使用时间、激素使用时间、白蛋白水平等因素是COPD急性加重肺部真菌感染的独立风险因素(P＜0.01)；真菌感染患者加用抗真菌药物治疗,治愈69例(83.13％),好转12例(14.46％),无变化l例(1.20％),死亡1例(1.20％).结论 患者高龄、住ICU时间长、长时间抗生素及激素及白蛋白水平低下是COPD急性加重期肺部真菌感染的独立风险因素,及时确诊并且抗真菌治疗患者预后较好.

Clinical analysis of fungus infection in acute exacerbation of chronic obstructive pulmonary disease

Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease（COPD） pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object（COPD fungal infection group）,according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences（P〈0.05）;The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors（P〈0.01）;Fungus infection were combined with antimycotic,cured 69 cases（83.13%） improved 12 cases（14.46%）,there was no change in 1 case（1.20%）,death 1 case（1.20%）.Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.