摘要
目的分析慢性阻塞性肺病(COPD)继发真菌性肺炎患者痰液细菌培养结果,并分析其发病高危因素。方法选择2016年1月至2019年1月我院收治的85例COPD继发真菌性肺炎患者纳为观察组,采集患者痰液标本进行真菌培养并统计培养结果。选择同期80例未发生真菌性肺炎的COPD患者作为对照组。比较两组患者性别、年龄、糖皮质激素使用情况等资料,并分析COPD患者继发真菌性肺炎的危险因素。结果 85例COPD继发真菌性肺炎患者中共检出87株病原性真菌。痰培养结果中白假丝酵母(41.38%)与曲霉菌属(28.74%)占比最高。观察组与对照组患者使用广谱抗菌药物、发生低蛋白血症、机械通气、糖皮质激素使用及合并糖尿病情况差异均有统计学意义(χ^2或t=19.55、20.82、14.53、22.77、7.43,P<0.05),而两组患者性别构成比及年龄差异无统计学意义(χ^2或t=0.17、1.61,P>0.05)。Logistic多因素回归分析提示,使用糖皮质激素与广谱抗菌药物、发生低蛋白血症及机械通气史均是导致COPD继发真菌性肺炎的独立危险因素(OR=7.493、4.802、5.900、1.799,P<0.05)。结论在预防COPD继发真菌性感染时应合理并控制性使用糖皮质激素与广谱抗菌药物,积极纠正低蛋白血症,缩短患者通气时间并保证在无菌条件下进行机械通气。
Objective To analyze the results of sputum culturing and risk factors of secondary fungal pneumonia in patients with chronic obstructive pneumonia(COPD). Methods A total of 85 COPD patients with secondary fungal pneumonia(observation group) and 80 COPD patients(control group) in our hospital from January 2016 to January 2019 were enrolled. The general data including gender, age and glucocorticoid dosage were collected and compared between groups. Then the independent risk factors of the secondary fungal pneumonia were determined by Logistic multivariate analysis. Results A total of 87 strains of pathogenic fungi were isolated among the 85 COPD patients with secondary fungal pneumonia. Candida albicans(41.38%) and Aspergillus(28.74%) accounted for the highest proportion in sputum culture. Univariate analysis showed significant differences in the use of broad spectrum antibiotics, hypoproteinemia, mechanical ventilation, glucocorticoid use and diabetes between groups(χ^2/t=19.55, 20.82, 14.53, 22.77, 7.43;P<0.05), while no statistical difference was found in the gender composition ratio and age(χ^2/t=0.17, 1.61;P>0.05). Logistic multivariate regression analysis showed that the use of Glucocorticoids and broad-spectrum antibiotics, hypoproteinemia, and mechanical ventilation were independent risk factors for secondary fungal pneumonia in COPD(OR=7.493, 4.802, 5.900, 1.799;P<0.05). Conclusion Measures including rational use of Glucocorticoids and broad-spectrum antibiotics, correction of hypoproteinemia, mechanical ventilation under sterile conditions, and shortened ventilation period have great clinical value in preventing secondary fungal pneumonia in COPD patients.
作者
吴映南
邵伯云
WU Yingnan;SHAO Boyun(Department of Respiratory Medicine,Haian People′s Hospital,Haian,Jiangsu226600,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第2期196-199,共4页
Chinese Journal of Microecology
关键词
慢性阻塞性肺病
继发性真菌性肺炎
痰培养
危险因素分析
Chronic obstructive pulmonary disease
Secondary fungal pneumonia
Sputum culture
Risk factors analysis
作者简介
吴映南(1990-),男,本科,从事呼吸内科研究,E-mail:chickenfeetf@126.com;通信作者:吴映南
