重型肝炎合并真菌感染相关因素分析

Analysis of Related Factors of Severe Hepatitis Complicating with Fungal Infections

目的:调查重型肝炎合并真菌感染的相关因素。方法:对2006年11月-2010年6月重型肝炎合并真菌感染住院患者进行前瞻性研究。结果:重型肝炎合并真菌感染率为26.1%(30/115),以白色念珠菌为主,占50.0%;感染部位以呼吸道为主,占76.7%;其感染因素为广谱抗菌药物、激素应用、白细胞减少、侵入性操作及疾病严重程度(P均<0.01);研究组与对照组病死率分别为70.0%(21/30)和50.6%(43/85)。多因素回归分析表明,死亡危险因素为侵入性操作、血白细胞减少和疾病严重程度。抗真菌治疗有效的患者肝功能呈好转趋势。结论:了解重型肝炎合并真菌感染的相关因素对疾病的预防、诊疗及预后改善具有重要意义。

OBJECTIVE： To study related factors of severe hepatitis complicating with fungal infections. METHODS： The data of severe hepatic patients with fungal infections from Nov. 2006 to Jun. 2010 were studied prospectively. RESULTS： The occurrence rate of severe hepatitis complicating with fungal infections was 26.1% （30/115）. Candida albicans accounted for 50.0%. Infectious rate in respiratory tract was 76.7%. The application of broad-spectrum antibiotics and corticosteroids, neutropenia, all kinds of invasive operation, severity of liver disease were significant risk factors for fungal infection （P〈0.01）. Mortality of study group and control group was 70.0% （21/30） and 50.6% （43/85） , respectively. In multivariate analysis, invasive operation, neutropenia and severity of liver diseases were risk factors to death. Liver function could be improved with effective anti-fungus therapy. CONCLUSION： Related factors of severe hepatitis complicating with fimgal infections are of importance to prevention, diagnosis and prognosis of disease.