【摘要】 目的探讨慢性阻塞性肺病合并肺部真菌感染的危险因素。方法选取慢性阻塞性肺疾病合并肺部真菌感染患者63例及同期未合并肺部真菌感染患者92例,对其临床资料急性回顾分析。对两组患者性别、年龄、抗生素和糖皮质激素使用时间、血清白蛋白含量、机械通气情况以及肝肾功能、合并症等进行统计分析。给予观察组患者氟康唑或伏立康唑治疗,随访3个月,对效果及预后进行统计。结果观察组患者年龄、性别、肝肾功能与对照组相比差异无统计学意义(P﹥0.05)。观察组患者血清白蛋白明显低于对照组;合并糖尿病、II型呼衰以及右心衰者明显多于对照组;观察组患者抗生素使用时间明显长于对照组,长期使用激素以及机械通气者明显多于对照组,上述比较差异有统计学意义(P﹤0.05)。其中机械通气、低蛋白血症、合并糖尿病、长期使用抗生素是较为独立的危险因素。63例患者均采取瑞辉制药生产的氟康唑或伏立康唑进行治疗,其中49例好转(77.78%),14例死亡(22.22%)。结论糖尿病阻塞性肺病合并肺部真菌感染患者的临床资料进行分析,其危险因素较为复杂。在临床工作中应充分考虑这些因素,采取积极的预防措施,尽量将肺部真菌感染的几率降至最低。更多还原

【Abstract】 OBJECTIVE To investigate the risk factors for chronic obstructive pulmonary disease with pulmonary fungal infections.METHODS 63 cases of chronic obstructive pulmonary disease with pulmonary fungal infections and 92 patients with unconsolidated pulmonary fungal infection were chosen as the research object in the same period.The clinical data were taken for review and analysis.The gender,age,use time of antibiotics and corticosteroids,serum albumin concentration,mechanical situation in the same period,liver and kidney function,and complications were taken for statistical analysis.Patients in the observation group were taken with fluconazole and voriconazole treatment,and were followed up for three months.The effect and prognosis was taken for statistics.RESULTS The age,gender,liver and kidney function in the observation group compared with the control group,there was not significant differences without statistical significance(P﹥0.05).The serum albumin in the observation group was significantly lower than the control group,and the diabetes mellitus type II respiratory failure,and right heart failure was significantly more than the control group.The antibiotic use in patients of the observation group was significantly longer than the control group,long-term use of hormones,and mechanical ventilation were significantly more than in the control group.There was significant difference(P﹤0.05).The mechanical ventilation,hypoproteinemia,diabetes and long-term use of antibiotics were the independent risk factors.63 patients were all taken with pharmaceutical production Ruihui fluconazole and voriconazole treatment,in which 49 cases improved(77.78%),and 14 cases died(22.22%).CONCLUSION The clinical data for diabetes obstructive pulmonary disease with pulmonary fungal infections are taken for analysis.The risk factors of diabetes obstructive pulmonary disease are more complicated.We should take full consideration for these factors,and take active preventive measures to minimize the risks of pulmonary fungal infections.更多还原