127例肺部真菌感染的临床分析

127 cases of pulmonary fungal infection

目的 探讨肺部真菌感染发病的易患因素、临床特征、治疗和预后。方法 应用回顾性调查的方法对 12 7例肺部真菌感染患者进行分析。结果 95 % (12 0 / 12 7)的病例患有基础疾病 ,其中以慢性阻塞性肺疾病 (COPD)、系统性红斑狼疮、白血病和慢性肾病为多见。肿瘤性疾病也占有重要位置 ,原发性肺部真菌感染少见。肺部真菌感染的临床表现无特异性 ,X线表现以支气管肺炎多见(6 1% ) ,病原菌主要以酵母菌属为主 (79 5 % ) ,早期诊断仍困难。肺部真菌感染病死率较高 ,基础病为慢性肾病和血液系统疾病其死亡风险的RR值较其他疾病大。结论 肺部真菌感染是多种疾病继发感染的重要原因 ,其临床表现特异性少 ,病死率高 ,发病呈上升趋势 ,应引起临床高度重视。

Objective To find out the clinical features, therapeutic outcome,prognosis and the major predisposing diseases of pulmonary fungal infection(PFI). Method 127 cases with PFI were retrospectively analyzed. Results Various predisposing diseases were found in 95% of total cases, among them, COPD,systemic lupus erythromatus(SLE),leukemia and chronic renal disease were main predisposing diseases. Primary pulmonary fungal infection was rare. All the clinical manifestations of PFI were not specific, reontgenographic features showed mainly bronchitis type(61%). Monilia (Candida) was ranked the first pathogen (79 5%). The mortality of PIF was high. Chronic renal and hematological diseases might be the risk factors for mortality (RR, relative rate, 5 14). Conclusions PFI is an important cause of the secondary infection in many diseases. The clinical features of PFI is non specific and the morbidity is rising. Clinicians should pay more attention to it