痰真菌培养在诊断慢性阻塞性肺疾病并发持续喘息中的应用研究

Sputum culture for fungi in diagnosis of chronic obstructive pulmonary disease complicated with persistent asthma

目的研究应用痰真菌培养在慢性阻塞性肺疾病并发持续喘息中的诊断意义,以期提高临床慢性阻塞性肺疾病并发持续喘息的诊断水平。方法选取医院收治的慢性阻塞性肺疾病患者80例,根据是否并发持续喘息分为持续喘息组38例,非喘息组42例,两组患者均进行痰真菌培养,并采用抗菌药物治疗,观察疗效。结果在持续喘息组共分离出病原菌55株,非喘息组分离出36株;持续哮喘组真菌感染26例,感染率68.42%,非喘息组仅有8例,感染率19.05%;应用氟康唑治疗,持续喘息组总有效25例总有效率65.79%,非喘息组总有效13例总有效率30.95%;应用伏立康唑治疗,持续喘息组总有效9例总有效率23.68%,非喘息组总有效率为0,两组差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病并发持续哮喘与真菌感染有关,应用痰真菌培养可以为临床诊断提供可靠的依据。

OBJECTIVE To study the clinical significance of sputum culture for fungi in diagnosis of chronic obstructive pulmonary disease complicated with persistent asthma so as to improve the level of diagnosis of chronic obstructive pulmonary disease complicated with persistent asthma.METHODS Totally 80cases of chronic obstructive pulmonary disease,who were treated in the hospital,were enrolled in the study and were divided into the persistent asthma group with 38cases and the non-asthma group with 42cases,then the sputum culture for fungi was performed for both of the two groups,the drug therapy was conducted,and the clinical efficacy was observed. RESULTS A total of 55strains of pathogens have been isolated from the persistent asthma group,36strains from the non-asthma group;there were 26（68.42%）cases of fungal infections in the persistent asthma group and 8（19.05%）cases in the non-asthma group.Through the drug therapy with fluconazole,the total effective rate of treatment was 65.79%（25cases）in the persistent asthma group,30.95%（13cases）in the non-asthma group; through the drug therapy with voriconazole,the total effective rate of treatment was 23.68%（9cases）in the persistent asthma group,0in the non-asthma group,the differences between the two groups were significant（P 0.05）.CONCLUSIONThe chronic obstructive pulmonary disease complicated with persistent asthma is associated with the fungal infections,and the sputum culture for fungi can provide reliable bases for the clinical diagnosis.