老年性支气管哮喘继发肺部真菌感染的特征及治疗

Secondary pulmonary fungal infection in older patients with bronchial asthma: a clinical feature and therapy

目的研究老年性支气管哮喘继发肺部真菌感染的病原菌及其临床特征及治疗。方法回顾性分析22例老年性支气管哮喘继发肺部真菌感染的临床资料。结果老年性支气管哮喘继发肺部真菌感染的病原菌分类为白色念珠菌占50%,热带银丝念珠菌占22.8%,光滑假丝念珠菌占13.6%,烟曲菌占9.1%。临床表现多样,与肺部基础疾病有关,多合并有细菌感染。抗真菌药敏感率依次为伊曲康唑100%,氟康唑93.73%,两性霉素90.32%,5-氟胞嘧啶83.87%,和制霉菌素73.07%。结论激素和抗生素合理应用是关键,一旦有真菌感染及时应用抗真菌药,宜按药敏选择。

Objective To investigate the type of pathogenic bacteria, clinical feature and therapy of secondary pulmonary fungal infection in older patients with bronchial asthma. Methods Clinical data of 22 older asthma patients with secondary pulmonary fungal infection were reviewed and analyzed. Results In terms of types of pathogenic bacteria, candida albicans was at the top （50%）, followed by candida tropicalis （22.8%）, candida glaber （ 13.6% ）, and aspergullus fumigatus （9. 1% ）. The clinical features had showed connection with pulmonary basic disease, and most with bacteria infection. In all fungistatic medication studied, the most sensitive one was itraconazole （ 10% ） , followed by fluconazole （93.73%） , amphotericin 990.32% ） , 5-FC （83.87）. and nystatin （73.03%）. Conclusion A reasonable use of hormone and antibiotics is the key in reducing secondary pulmonary fungal infection in older patients with bronchial asthma. Once infected with fungal, prompt treatment using fungistic medication should be made. The choice of the priority of the medications should be given to those with high sensitivity in testing.