49例慢性阻塞性肺疾病合并肺部真菌感染的临床分析

Chronic obstructive pulmonary disease accompanying fungal infection in 49 patients:A clinical analysis

目的观察慢性阻塞性肺疾病合并肺部真菌感染的病原菌分布、临床特点及治疗情况。方法结合文献及临床病例回顾分析49例我院收治的慢性阻塞性肺疾病合并肺部真菌感染的深部痰液进行培养鉴定情况、临床资料及治疗效果。结果 49例慢性阻塞性肺疾病合并真菌感染的患者检出白色念珠菌23例,热带念珠菌7例,光滑念珠菌4例,近平滑念珠菌3例,克柔念珠菌2例,曲霉菌10例。经氟康唑和伏立康唑早期治疗后痊愈9例(18.4%),有效27例(55.1%)。结论早期诊断、早期治疗可减少慢性阻塞性肺疾病继发肺部真菌感染的死亡率、提高临床疗效。

Objective To observe the pathogens,clinical features,diagnosis and treatment of chronic obstructive pulmonary disease（COPD） accompanying fungal infection.Methods Clinical data about 49 patients with COPD accompanying fungal infection admitted to our hospital,including their sputum identification and therapeutic effects,were retrospectively analyzed.Results Candida albicans,tropicalis,glabrata,parapsilosis,krusei,and Aspergillus were detected in the cultured sputum from 23,7,4,3,2,and 10 out of the 49 patients with COPD accompanying fungal infection.Complete recovery and effective outcome were achieved in 9（18.4%） and 27（55.1%）patients,respectively,after treatment with fluconazole and voriconazole.Conclusion Early diagnosis and treatment of COPD can improve its clinical curative effect and reduce its mortality.