80例老年肺结核继发肺部真菌感染临床相关因素分析

Analysis on clinical correlated factors of 80 cases of elderly pulmonary tuberculosis complicated by fungus infection

目的探讨老年肺结核继发肺部真菌感染的危险因素、临床特点及诊治方法。方法回顾性分析2004—2008年80例老年肺结核患者入院时常规真菌检测。对肺部真菌感染的相关基础疾病、病原菌分类、药敏状况及治疗结果进行统计分析。结果老年肺结核继发肺部真菌感染病史长,均有基础疾病,均用过抗生素。以白色念珠菌为主,占70%且耐药率低。随着肺内病变的増多,真菌感染的发生率増加,以肺内病变占据≥3个肺野多见(占75%)。真菌感染易发生在病变以纤维化为主的肺结核患者(占80%)。结论老年肺结核较易继发肺部真菌感染,应加强抗生素及肾上腺皮质激素的规范应用,以减少真菌感染及其耐药率的发生,有利结核病控制及减少死亡。

Objective To study the risk factors,clinical character and means of diagnosis of elderly pulmonary tuberculosis with fungus infection.Methods Results of fungus culture,basis disease and therapy in elderly pulmonary tuberculosis were analyed.Results The elderly pulmonary tuberculosis alway had long history of using antibiotic therapy and they were easily affected by fungus infection especially by candida albicans（70%）,The resistant rates were low in candida albicans.the incidence of fungi infection increased with the increase of lung lesion areas,especially lesion areas were more than three lung fields（75%）.The patients with pulmonary tuberculosis complicated with fibrosis were easily infected by fungi（80%）.Conclusion It is common that fungal infection occurredin elderly pulmonary tuberculosis cases.Standardized application of antibiotic and hormone should be strengthened to reduce the rate of fungal infection and their resistance rater,which will be contribute to tuberculosis control and reduce death rate.