慢性肝衰竭患者真菌感染的危险因素分析

Risk factors for fungal infections in patients with chronic liver failure

目的探讨慢性肝衰竭患者真菌感染的相关危险因素,为临床防治提供依据。方法选取广州中山大学附属第三医院2010年1月-2012年1月收治的60例慢性肝衰竭合并真菌感染患者作为研究对象,设为感染组,将同期未发生真菌感染60例患者设为对照组,对两组患者感染相关因素进行对比分析。结果感染组病死率10.0%,明显高于对照组的5.0%,差异有统计学意义(P<0.05);感染组细菌感染率、抗菌药物使用率及侵入性操作例数分别为78.33%、93.33%、55例,对照组分别为18.33%、46.67%、18例,两组差异有统计学意义(P<0.05);logistic回归分析显示,住院期间合并细菌感染种类、总胆红素指数、住院天数、使用抗菌药物累积时间、侵入性操作及使用抗菌药物种类是慢性肝衰竭患者真菌感染的独立危险因素(P<0.05)。结论针对慢性肝衰竭患者真菌感染相关危险因素,采取积极的防治措施,能有效地降低真菌感染率。

OBJECTIVE To analyze the related risk factors for fungal infections in patients with chronic liver failure so as to guide the clinical treatment. METHODS A total of 60 cases of chronic liver failure patients complicated with fungal infections, who were treated in the hospital from Jan 2010 to Jan 2010, were enrolled in the study and assigned as the infection group, and 60 cases of patients without infections were set as the control group, then the related factors for the infections were analyzed and compared between the two groups. RESULTS The mortality of the infection group was 10.0 %, significantly higher than 5.0 % of the control group, the difference was significant （P〈0. 05）. The incidence of bacterial infections was 78. 33% in the infection group, 18. 33% in the control group; the utilization rate of antibiotics was 93.33 % in the infection group, 46.67 % in the control group; there were 55 cases of patients who underwent the invasive operation in the infection group and 18 cases in the control group, the difference between the two groups was significant （P〈0.05）. The logistic regression analysis showed that the species of pathogens causing infection during hospital stay, total bilirubin index of liver function, length of hospital stay, cumulative time of use of antibiotics, invasive operation, and types of antibiotics used were the independent risk factors for fungal infections in the patients with chronic liver failure. CONCLUSION It is necessary to take positive prevention measures aiming at the related risk factors for the fungal infections in the patients with chronic liver failure so as to effectively reduce the incidence of fungal infections.