重度支气管哮喘并发下呼吸道真菌感染的危险因素分析及预防

Analysis on the Risk Factors and Prevention Countermeasures of Severe Bronchial Asthma Complicated by Fungal Infections of Lower Respiratory Tract

目的分析重度支气管哮喘并发下呼吸道真菌感染的危险因素,并探讨其预防对策。方法选择2011年2月至2013年2月安新县医院收治的58例重度支气管哮喘并发下呼吸道真菌感染患者作为研究组,另选取同期收治的58例未合并下呼吸道真菌感染患者作为对照组,采用Logistic回归分析影响下呼吸道真菌感染发病的危险因素。结果单因素Logistic回归分析结果显示,年龄、侵入性操作、呼吸机使用、体外插管、糖皮质激素使用时间、抗生素使用情况、基础疾病及并发症是重度支气管哮喘并发下呼吸道真菌感染发病的独立影响因素(P<0.05)。多因素Logistic回归分析结果显示,抗生素的使用、基础疾病对模型的影响较大,而糖皮质激素使用对并发下呼吸道真菌感染影响最大(P<0.05)。结论缩短糖皮质激素使用时间、合理使用抗生素以及积极控制基础疾病是降低重度支气管哮喘并发下呼吸道真菌感染发病率的有效途径。

Objective To analyze the risk factors of severe bronchial asthma complicated by fungal infections of lower respiratory tract, and explore its prevention countermeasures. Methods A total of 58 cases of patients with severe bronchial asthma complicated by fungal infections of lower respiratory tract admitted in Anxin County Hospital from Feb. 2011 to Feb. 2013 were selected as observation group, and another 58 cases of patients with only severe bronchial asthma not complicated by fungal infections of lower respiratory tract during the same period were selected as control group, relativity of each factor with fungal infections of lower respiratory tract was analyzed using Logistic regression analysis method. Results Results of single factor Logistic regression analysis showed ： age,invasive operation, use of respirator, vitro intubation, glucocorticoid usage time, use of antibiotics, basic diseases and complications were independent factors of severe bronchial asthma complicated by fungal infections of lower respiratory tract （ P 〈 0.05 ）. Results of multivariate Logistic regression analysis showed ： use of antibiotics and basic diseases had great effect on the module, however use of glucocorticoid had very high relevance to the concurrence of fungal infections of lower respiratory tract （ P 〈 0.05 ）. Conclusion Short glucocorticoid usage time, proper use of antibiotics and positive control of basic diseases are the effective ways to reduce incidence of severe bronchial asthma complicated by fungal infections of lower respiratory tract.