乳腺癌患者肺部真菌感染的临床特点分析

Analysis of clinical characteristics of lung fungal infections in patients with breast cancer

目的分析乳腺癌患者肺部真菌感染的临床特点，为其临床预防治疗及抗菌药物使用提供理论指导。方法回顾性调查肿瘤内科2010年4月-2013年4月收治的295例乳腺癌患者，对其肺部真菌感染进行分析。结果295例患者中共发生肺部感染42例，感染率14．24％；共检出真菌55株，以白色假丝酵母菌最多，占61．82％；患者肿瘤分期、白细胞（WBC）水平、抗菌药物应用时间长差异有统计学意义（P〈0．05），其与年龄、侵入性操作差异无统计学意义；多因素回归分析发现，肿瘤分期Ⅲ-Ⅳ期、WBC％2×10^9。／L及抗菌药物应用≥14d是导致乳腺癌患者肺部真菌感染的独立危险因素（P〈0．05）。结论乳腺癌患者肺部真菌感染以白色假丝酵母菌为主，而肿瘤分期Ⅲ～Ⅳ期、WBC〈2×10^9。／L及抗菌药物应用≥14d是导致其感染率增加的主要原因，应做好抗菌药物的使用及相关支持治疗，最大限度降低患者感染的发生，同时，应密切关注患者感染症状，做到早发现、早治疗，保证其生存率。

OBJECTIVE To analyze the clinical characteristics of lung fungal infections in patients with breast cancer, so as to provide theoretical guidance for clinical prevention and antibacterial drugs in breast cancer patients with pulmonary infections. METHODS A total of 295 cases of breast cancer patients were investigated retrospectively from Apr. 2010 to Apr. 2013 admitted to the department of internal medicine, and the pulmonary fungal infection were analyzed. RESULTS A totai of 295 patients were detected, in which 42 cases with pulmonary infections, and the infection rate was 14.24%. A total of 55 strains of pathogenic fungi were detected, in which Candida albicans was the most, accounting for 61.82~; two groups of patients with tumor stage, the level of WBC, antirnicrobial application time had significant difference （P〈0.05）, while the age, invasive operation had no significant difference. In multi factor regression analysis, tumor stage Ⅲ-Ⅳv, WBC〈2 × 10^9/L and application of antimicrobial agents in breast cancer ≥ 14 d were the independent risk factors of patients with pulmonary fungal infections （P〈 0. 05）. CONCLUSION C. albicans pulmonary fungi are the main cause for infections, and the tumor stage Ⅲ-Ⅳ , WBC〈2 × 10^9/L and application of antimicrobial agents in breast cancer ≥ 14 d are the main cause for the infection rate increase. In the treatment of the future, antibiotics and related supportive treatment should be used rationally to minimize the occurrence of infections. At the same time, we should pay close attention to symptoms of infections, in order to ensure the survival rate by early detection, early treatment.