继发性肺结核合并肺部真菌感染的临床特点及危险因素分析

Clinical characteristics and risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection

目的探讨继发性肺结核合并肺部真菌感染的临床特点及相关高危因素。方法收集广州市胸科医院2017年7月—2019年10月收治的继发性肺结核患者资料,病程均大于3个月,分为真菌感染组106例和非真菌感染组100例进行回顾性分析。结果单因素分析结果显示,合并肺部其他疾病、非初治、咯血、空洞、应用广谱抗生素>l周、侵袭性操作存在统计学差异(P<0.05)。Logistic多因素分析结果显示,广谱抗生素使用>l周、侵袭性操作为真菌感染的独立危险因素(P<0.05)。结论对于应用广谱抗生素、进行侵袭性操作的肺结核患者应警惕真菌感染风险,及早预防及诊治。

Objective To investigate the clinical characteristics and related high risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection.Methods Data of patients with secondary tuberculosis admitted to Guangzhou Chest Hospital from July 2017 to October 2019 were collected.All patients with a course of disease longer than 3 months were divided into the fungal infection group(n=106)and the non-fungal infection group(n=100)for retrospective analysis.Results Univariate analysis results showed that there were statistical differences in combined other pulmonary diseases,non-initial treatment,hemoptysis,cavity,application of broad-spectrum antibiotic>for 1 week,and invasive operation(P<0.05).Logistic multivariate analysis showed that>1 week of broad-spectrum antibiotics and invasive procedures were independent risk factors for fungal infection(P<0.05).Conclusion Patients with tuberculosis who are treated with broad-spectrum antibiotics and invasive procedures should be alert to the risk of fungal infection,early prevention and treatment should be undertaken.