大蒜素注射液对机械通气相关性下呼吸道深部真菌感染的预防效果及临床意义

Preventive Effect and Clinical Significance of Garlicin Injection on Mechanical Ventilator-Associated Low Respiratory Tract Deep-seated Fungal Infection

目的探讨大蒜素注射液对机械通气相关性下呼吸道深部真菌感染的预防效果及临床意义。方法回顾分析近 3年在我科ICU接受机械通气治疗的 14 7例患者 ,其中 79例下呼吸道深部真菌感染危险度评分≥ 2 5 ,根据是否使用大蒜素注射液作预防性用药 ,将 79例分为预防组和对照组 ,比较分析两组在基础情况、机械通气相关性下呼吸道深部真菌感染的发生率及最后结局方面的差别。结果预防组和对照组在年龄、性别、APACHEⅡ评分、SAPSⅡ评分和WVUH评分方面差异无显著性。对照组机械通气相关性下呼吸道深部真菌感染的发生率显著高于预防组 (P <0 0 1) ,其相对危险度RR为 2 0 6 (95 %CI ,1 2 5～ 3 38)。两组在病死率上差异无显著性 (P >0 0 5 )。结论大蒜素注射液可有效降低机械通气相关性下呼吸道深部真菌感染的发生率 ,而且价格低廉 。

ObjectiveTo investigate the preventive effect and clinical significance of garlicin injection on ventilator associated low respiratory tract deep seated fungal infection (VRFI) as pneumonia. MethodsRetrospectively analysis on 147 patients underwent mechanical ventilation in our Intensive Care Unit (ICU) in recently 3 years was conducted. According to the garlicin injection administration was used or not, 79 patients with WVUH (West Virgina University Hospital) score ≥25 points were selected and divided into the preventive group and the control group, and the differences in baseline conditions, incidence of VRFI and hospital outcome between the two groups were compared. ResultsThere was no significant difference between the two groups in baseline data as age, sex, APACHEⅡ score, SAPSⅡ score and WVUH score. But the incidence of VRFI in the preventive group was significantly lower than that in the control group (P<0 01). The relative risk in the latter was 2 06 (95%CI, 1 25-3 38). No significant difference was found between the two groups in hospital mortality (P>0 05). ConclusionGarlicin injection can effectively reduce the incidence of VRFI, and is inexpensive, it is an ideal prophylactic anti fungal drug.