肺结核合并肺部真菌感染的临床分析

目的分析肺结核合并肺部真菌感染的临床特点、原因及治疗措施。方法对本院2008年6月～2010年12月52例肺结核合并肺部真菌感染的患者资料进行回顾性分析，总结肺结核合并肺部真菌感染的临床特点、发病原因及治疗方法。结果肺结核合并肺部真菌感染的患者无特异性临床表现，感染的原因主要是长期使用广谱抗生素、糖皮质激素以及患者免疫力低下等。52例患者均根据痰菌培养结果及药敏试验对症给予抗真菌药物氟康唑、两性霉素B等治疗，49例患者痰菌培养结果转阴，1例白色念珠菌感染患者仍然为阳性，2例患者发生多器官衰竭死亡。结论老年、长期使用抗生索、肺结核反复复发等是肺结核并发真菌感染的高危因素，临床应加强对真菌感染高危患者的预防并及早采用经验性抗真菌治疗。

The clinical analysis for tuberculosis combined with pulmonary fungal infection

Objective To analyze the clinical characteristic, causes and treatment for tuberculosis combined with pul- monary fungal infection. Methods 52 eases of tuberculosis combined with pulmonary fungal infection treated in our hospital from June 2008 to December 2010 were retrospectively analyzed. Pulmonary tuberculosis,the clinical features of fungal infec- tion, pathogenesis and treatment were summarized. Results There was no specific characteristic in the clinical application for tuberculosis combined with pulmonary fungal infection. The main reason for infection was long - term use of broad - spectrum antibiotics, corticosteroids, and patients with low immunity, etc. 52 patients were given antifungal fiueonazole and amphoteriein B treatment based on sputum culture results and susceptibility testing symptomatic, the sputum culture results of 49 patients changed negative, one case of Candida albicans infection was still positive, two patients died of organ failure, accounting for 3.85 %. Conclusion Elderly,long - term use of antibiotics, tuberculosis, repeated recurrence of tuberculosis were the high - risk factors for tuberculosis combined with pulmonary fungal infection. The clinical application should strengthen the prevention of fungal infection in high - risk patients and use of empirical antifungal therapy early.