激素依赖型哮喘继发真菌性肺炎的诱因分析

The Risk Facter of Fungi Pneumonia after the Bronchus Asthma with Hormone Dependence

目的:探讨长期大量不规则应用激素的支气管哮喘患者继发真菌性肺炎的诱因,总结支气管哮喘患者管理中应注意的问题。方法:分析17例激素依赖型哮喘患者的症状、体征、辅助检查、治疗及转归,并与随机选择同期住院的的17例支气管哮喘患者进行年龄、病程、激素应用时间及用量、夹杂症及合并症、抗生素应用情况的对比。结果:观察组与对照组比较,观察组患者年龄大,病程长,常合并严重并发症或其他疾病,激素应用时间长、量大、不规则,抗生素应用种类多,时间长。结论:支气管哮喘患者本身存在气道炎症,加之反复发作、病程长,常并发严重肺部病变,局部抵抗力低下,加上某些病例合并有糖尿病、肺结核、全身营养不良等,致机体抵抗力低下,在此基础上长期、反复大量应用激素,致机体抵抗力进一步低下,同时较长时间应用广谱抗生素或多种抗生素致体内菌群失调,使对抗生素不敏感的真菌增殖和侵袭机体,发生真菌感染。

Objective：Inquiry into the bronchus asthma about the fungi pneumonia after the brunchus asthma sufferer that long time, large volume, irregular pattern of the usage of hormone, tally up the bronchus asthma sufferer management in the problem that should notice. Methods：To observe the symptom, body sign, assistant examination,laboratory examination and treatmrnt of 17 case persons form the brunchus asthma of hormone dependence,and to compare the age, the course of diserse, the time and volume of the usage of hormone, the mingled symptom and the consolidated symptom,and the usage condition of antibiotic. Results：Acoording to the comparision to the observed group and the comparative group, we found that the suffering persons of observed groups are always older,have longer course of diserse and more serious consolidated symptom or other serious diserse （such as pulmonary tuberculosis,diabetes and so on ）, long time large volume, irregular pattern of the usage of hormone, and more varieties of the usage of antibiotic. Conclusion： The bronchus asthma suffers have the inflammation in pharynx, which has longer course of diserse and brerks out over and over again,and which can lend to serious pathological charges in lungs, for example,COPD,chronic pulmonary heart disease, serious infection in lungs, the lower local resistance to disase, and some disease with diabetes mellitus, pulmonary tuberculosis,and malnutrition in the body cause the lower resistance to diserse in the body, and what is more serious is the long-term,and repeated uses of hormone, which lend to lower and lower resistance to disease in the body,and at the same time,long time uses to the antibiotic cause the imbalance of the bacterium in the body,and the fungus which is no sensitivity to antibiotic reproduce and attack the body,and the fungus will be infected.