老年慢性阻塞性肺疾病继发肺真菌病的危险因素研究

Risk factors for pulmonary fungal infection in the elderly patients with chronic obstructive pulmonary disease

目的分析并探讨老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者继发肺部真菌感染的危险因素,从而为更好地降低真菌感染率提供预防措施。方法选取2010年3月至2014年3月,我院接受治疗的老年COPD患者86例。根据患者是否继发肺真菌感染将其分为感染组与非感染组,分别为46例和40例,回顾性分析2组患者临床资料,分析并探讨2组患者间差异,利用单因素分析与多因素分析方法进一步探讨继发肺真菌感染的高危因素。结果感染组糖尿病人数占23.91%,机械通气人数占45.65%,呼吸衰竭人数占63.04%,激素使用人数占84.78%,营养不良人数占50.00%,各项指标均明显高于非感染组(P<0.05)。感染组抗菌药物使用时间(18.32±3.78)d,明显高于非感染组(P<0.05);感染组白蛋白含量(31.34±4.54)g/L,明显低于非感染组(P<0.05)。COPD患者继发肺部真菌感染与低白蛋白血症、呼吸衰竭、机械通气相关。结论分析老年COPD患者继发肺部真菌感染的危险因素,对探讨有效的预防措施、降低感染率有重要意义。

Objective To investigate the risk factors for pulmonary fungal infection in the elderly patients with chronic obstructive pulmonary disease. Methods From March 2010 to March 2014,86 elderly patients with COPD in our hospital were enrolled in this study. They were divided into infection group（ n = 46） and non-infection group（ n = 40） according to the fungal infection status. The clinical data were retrospectively analyzed with single-factor analysis and multivariate analysis to further explore the risk factors for secondary pulmonary fungal disease. Results The incidence of diabetes,mechanical ventilation,respiratory failure,hormones using,and malnutrition was 23. 91%,45. 65%,63. 04%,84. 78% in the infection group,which were significantly higher than those in non-infection group（ P〈0. 05）. The using time of antimicrobial drug in infection group was significantly higher than that in non-infection group（ P〈0. 05）. The level of albumin was significantly lower in infection group than that in the non-infection group（ P〈0. 05）. The secondary pulmonary fungal infection in the patients with COPD was related with hypoalbuminemia,respiratory failure,mechanical ventilation. Conclusions Analysis of the risk factors for secondary pulmonary fungal infection in the elderly patients with COPD help to explore the effective preventive measures to reduce the infection rate.