危重症患者侵袭性真菌病风险评估模型临床应用进展

Development of risk evaluation models for critically ill patients at high risk of invasive fungal disease

侵袭性真菌病（invasive fungal disease，IFD）是导致重症监护病房患者死亡的原因之一，近年来越来越多发生于非粒细胞缺乏的危重患者，早期诊断以及准确地筛选高危患者进行预防性抗真菌治疗逐渐得到重视。应用统计学多因素分析方法确立IFD相关危险因素，并建立真菌感染风险评估模型。念珠菌评分可用于选择高危患者接受早期抗真菌治疗。该文就非粒细胞缺乏的危重患者真菌感染风险评估模型的建立及验证进行综述。

Invasive fungal disease （IFD）is one of the causes leading to death in intensive care unit, and now more likely to occur in non-neutropenic critically ill patients. Early diagnosis and appropriate selection of patients at high risk of IFD to receive prophylactic antifungal therapy are of great concern. Risk factors related to IFD were established by multivariable analysis and then risk evaluation models were developed. Candida score could accurately select patients who would benefit from early antifungal treatment. Evaluation and validation of risk models for non-neutropenic critically ill patients at high risk of IFD were reviewed in this article.