慢性阻塞性肺疾病急性加重期患者肺部真菌感染的相关因素分析

Analysis of Related Factors of Pulmonary Fungal Infection in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探讨慢性阻塞性肺疾病(慢阻肺)急性加重期患者肺部真菌感染的影响因素。方法:回顾性分析2018年7月~2019年12月于某院接受治疗的76例慢阻肺急性加重期患者临床资料,所有患者均进行痰液真菌培养,根据培养结果将42例并发肺部真菌感染患者纳入感染组,将34例未并发肺部真菌感染患者纳入未感染组,统计两组一般资料,经单因素、多因素Logistic回归分析导致慢阻肺急性加重期患者肺部真菌感染的影响因素。结果:感染组年龄≥70岁、合并低蛋白血症、糖尿病及呼吸衰竭、机械通气、糖皮质激素使用时间≥10d及抗菌药物使用时间≥14d占比高于未感染组,差异有统计学意义(P<0.05);感染组性别、有无高血压、有无慢性心力衰竭、有无吸烟史与未感染组相比,差异无统计学意义(P>0.05);经多项Logistic回归分析证实,年龄≥70岁、合并低蛋白血症、糖尿病及呼吸衰竭、机械通气、糖皮质激素使用时间≥10d、抗菌药物使用时间≥14d是慢阻肺急性加重期患者肺部真菌感染的影响因素(OR>1,P<0.05)。结论:年龄≥70岁、合并低蛋白血症、糖尿病及呼吸衰竭、机械通气、糖皮质激素使用时间≥10d、抗菌药物使用时间≥14d是慢阻肺急性加重期患者肺部真菌感染的影响因素,临床需采取相应措施进行干预,以期降低肺部真菌感染发生率。

Objective:To investigate the influencing factors of pulmonary fungal infection in patients with chronic obstructive pulmonary disease(COPD)in the acute exacerbation stage.Methods:The clinical data of 76 patients with acute exacerbation of chronic obstructive pulmonary disease who were treated in a hospital from July 2018 to December 2019 were retrospectively analyzed.All patients underwent sputum fungal culture.According to the results of the culture,42 cases complicated with pulmonary fungal infections were included in the infection group,and 34 patients without pulmonary fungal infection were included in the uninfected group.The general data of the two groups were calculated.The univariate and multivariate logistic regression methods were used to analyze the influencing factors which led to the pulmonary fungal infections in patients with acute exacerbation of COPD.Results:The proportion of age≥70 years old,combined with hypoproteinemia,diabetes and respiratory failure,mechanical ventilation,glucocorticoid use time≥10 days,and antibacterial drug use time≥14 days in the infection group was higher than that of the uninfected group.The difference was statistically significant(P<0.05).Compared with the uninfected group,there was no statistically significant difference in gender,hypertension,chronic heart failure,and smoking history in the infection group(P<0.05).Multiple logistic regression analysis confirmed that the age≥70 years old,combined with hypoproteinemia,diabetes and respiratory failure,mechanical ventilation,glucocorticoid use time≥10d,antibacterial drug use time≥14d were the influencing factors of pulmonary fungal infection in patients with acute exacerbation of chronic obstructive pulmonary disease(OR>1,P<0.05).Conclusion:Age≥70 years old,combined with hypoproteinemia,diabetes and respiratory failure,mechanical ventilation,glucocorticoid use time≥10d,antibacterial drug use time≥14d are the influencing factors of pulmonary fungal infections in patients with acute exacerbation of chronic obstructive pulmonary disease.Corresponding measures should be taken for clinical intervention in order to reduce the incidence of pulmonary fungal infections.