呼吸内科肺部真菌感染危险因素分析

Analysis of risk factors for pulmonary fungal infections in respiratory department

目的分析肺部真菌感染(PFI)的危险因素,为PFI临床防治提供依据。方法采用单因素分析、多因素Logistic回归分析方法对86例PFI患者及89例非PFI患者的临床资料进行回顾性分析。结果 PFI组与非PFI组患者的平均年龄、性别分布无明显差异(P>0.05)。两组患者的平均住院时间、吸烟史、慢性阻塞性肺疾病、留置尿管、中心静脉置管、机械通气、糖皮质激素使用时间>2周、近期使用广谱抗生素>2周和低蛋白血症比较均有统计学差异(P<0.05)。Logistic多因素回归分析显示:留置尿管(P=0.044,OR=3.142)、使用糖皮质激素>2周(P=0.012,OR=3.369)、使用广谱抗生素>2周(P=0.005,OR=3.138)和低蛋白血症(P=0.018,OR=2.389)是发生肺部真菌感染的危险因素。结论长期使用糖皮质激素、广谱抗生素、留置尿管和低蛋白血症是引起肺部真菌感染的独立危险因素。

Objective To explore the risk factors of pulmonary fungal infection（ PFI） and provide evidences for its clinical effective prevention and treatment. Methods A retrospective case-control study was conducted in 86 cases of PFI and 89 cases of non-PFI.Single factor analysis method was used to select the risk factors,and multivariate Logistic regression analysis method was used to screen the independent risk factors of pulmonary fungal infections. Results There was no significant difference in average age and sex between PFI group and non-PFI group. The length of hospital stay,smoking history,chronic obstructive pulmonary disease,indwelling catheter,central venous catheterization and mechanical ventilation,long duration of corticosteroid use 2 〉weeks,long use of broad-spectrum antibiotics 〉2 weeks,hypoproteinemia were related to the presence of PFI（ P〈0.05）. Multivariate Logistic regression analysis showed that indwelling catheter（ P = 0. 044,OR = 3. 142）,long duration of corticosteroid use 2 weeks（ P = 0. 012,OR = 3. 369）,long use of broad-spectrum antibiotics〉 2 weeks（ P = 0. 005,OR = 3. 138） and hypoproteinemia（ P = 0. 018,OR = 2. 389） were the major risk factors for the occurrence of pulmonary fungal infection. Conclusion The long-term use of corticosteroid and broad-spectrum antibiotics,indwelling catheter and hypoproteinemia may be the independent risk factors of pulmonary fungal infection.