肺结核合并白色念珠菌感染86例临床分析

Clinical analysis of pulmonary tuberculosis with candida albicans infection in 86 cases

目的分析肺结核合并白色念珠菌感染的易患因素、临床特征、治疗和预后，探讨两病并存的早期诊断与治疗方法。方法回顾86例肺结核合并白色念珠菌感染的临床资料，并进行分析。结果肺部白色念珠菌感染的临床表现无特异性，X线表现除肺结核征象外，主要表现为合并中下肺片状模糊阴影；易患因素多见于：长期使用广谱抗生素，联用多种抗生素、糖皮质激素或免疫抑制剂，长期卧床，体质衰弱，住院时间过长，慢性支气管炎和阻塞性肺疾病（COPD），呼吸衰竭，糖尿病，低蛋白血症，血液系统疾病，多脏器衰竭，机械通气等；肺部真菌感染病死率较高。结论肺结核合并白色念珠菌感染多为继发感染，明确诊断后，在抗结核治疗的同时给予抗真菌治疗有效。

Objective To analyze the merger candida albicans pulmonary tuberculosis infection risk factors, clinical characteristics, treatment and prognosis, ways of improving the coexistence of the two diseases in the early diagnosis and treatment methods. Methods 86 cases with pulmonary tuberculosis combined candida albicans infection were analyzed. Results Pulmonary lung infection candida albicans no specific clinical manifestations, in addition to X-ray signs of tuberculosis,mainly for the merger under the shadow of lung flake fuzzy; prediction for risk factors： long-term use of broad-spectrum antibiotics, the multi-antibiotics, glucocorticoid or immunosuppressants, long-term bed rest, physical weakness, the length of hospitalization, chronic bronchitis and obstructive pulmonary disease （COPD）, respiratory failure, mechanical ventilation, diabetes, hypoproteinemia, blood diseases, multiple organ failure, mechanical ventilation,and other invasive operation is closely related to a higher mortality rate of pulmonary fungal infections. Conclusion Active tuberculosis disease and therapy to reduce risk factors ,prevention and early diagnosis of good, reasonable use of antibiotics, hormones, and so on, the key is to improve the cure rate.