自身免疫病合并真菌感染的临床分析

Fungal Infection in Autoimmune Disease Patients:A Clinical Study

目的探讨自身免疫病(AD)合并深部真菌感染的危险因素、病原菌分布、种类及防治措施。方法回顾性分析186例AD患者合并真菌感染38例的临床及实验室资料。结果AD合并深部真菌感染主要分布在下呼吸道(51.2%)、泌尿道(19.5%);主要病原菌为白色假丝酵母菌28株(70.0%),主要的危险因素与AD患者免疫功能紊乱及大量、长期应用激素、免疫抑制剂、广谱抗菌药物有关(均P<0.05)。结论合理应用激素、免疫抑制剂及抗菌药物,发现真菌感染应尽早在药敏试验结果指导下进行抗真菌治疗,并加强综合支持治疗。

OBJECTIVE To identify the risk factors, distribution and kinds of pathogens and control measures for the patients with autoimmune disease （AD） complicated with fungal infections. METHODS Statistical analysis was carried out on the clinical data of 38 patients with AD complicated with fungal infaction. RESULTS The fungal infection in AD mainly occurred in the respiratory tract, urinary tract, digestive tract and on the skin. The main factors of these patients more likely were disturbed immunity, and unreasonable usage of corticosteroids, immunosuppressive agents and antibiotics. CONCLUSIONS It should as early as possible onset the clinical antifungal therapy, reasonable using of corticosteroids, immunosuppressive agents and antibiotics for fungal infaction, and supportive treatment according to the result of antifungal susceptibility test.