慢性阻塞性肺疾病急性加重期患者的抗真菌治疗分析

Study on the Antifungal Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

目的分析具有真菌感染危险因素的慢性阻塞性肺疾病急性加重期患者人群中所进行的短程抗真菌治疗。方法收集60例的慢性阻塞性肺疾病急性加重患者临床资料,其中合并糖尿病32例,入院前接受广谱抗生素治疗的51例,共同特点包括气喘难以控制、合格痰标本≥2次检出真菌、肺部无浸润性阴影,接受短时间抗真菌治疗的32例,未行抗真菌治疗的28例,以糖皮质激素总剂量及住院时间为观察指标。结果接受抗真菌治疗患者的上述指标均低于无抗真菌治疗患者。结论具有真菌感染危险因素的慢性阻塞性肺疾病患者,在急性加重期如果气喘难以缓解、合格痰标本≥2次检出真菌以及肺部无浸润性阴影的情况下,适时进行短程抗真菌干预,有利于减少全身糖皮质激素用量及住院时间。但是对于抗真菌治疗的副作用,仍需充分评估。

Obieetive To investigate the short term antifungal therapy in acute exacerbations of chronic obstructive pulmonary disease patients with high fungi infection risk. Method 60 AECOPD patients with severe wheezing and twice or more qualified sputum specimens fungi positive were analyzed retrospectively, all of cases were no infiltration patches on chest radiograph,32 cases were treated with short term antifungal treatment, the dosage of glucoeorticoid and length of hospital stay were as observation indexes. Results The indexes of the patients taking antifungal treatment were lower than that of untreated patients. Conclusion AECOPD patients with high fungi infection risk with severe wheezing and twice or more qualified sputum specimens fungi positive, a short term of timely antifungal therapy was effective in treatment. However, the side effect of antifungal treatment should be fully assessed.