【摘要】 目的 探讨慢性阻塞性肺疾病(COPD)急性加重期患者继发真菌感染的危险因素。方法 回顾性分析2011年1—12月首都医科大学附属北京朝阳医院收治的794.例C0PD急性加重期患者的临床资料。将患者分为继发真菌感染组(140例)和非继发真菌感染组(654例)。纳入20项危险因素进行单因素和多因素非条件Logistic回归分析。结果 单因素非条件Logistic回归分析显示,真菌感染史、低白蛋白血症、呼吸衰竭、肾功能不全、住院时间、入住重症监护病房时间、中心静脉置管、鼻饲胃管、留置导尿管、外周静脉高营养、有创及无创机械通气、类固醇激素使用时间、抗生素使用时间及种类均为COPD急性加重期患者继发真菌感染的相关危险因素(均P<0.05)。多因素非条件Logistic回归分析显示,真菌感染史、类固醇激素使用时间>2周、抗生素使用时间>2周、有刨机械通气、中心静脉置管、抗生素使用种类>2种是C0PD患者继发真菌感染的主要危险因素,比值比分别为63.319,3.193,1.691,1.615,2.002,2.040,均P<0.05。结论 真菌感染史、使用类固醇激素时间长、有创机械通气、抗生素使用时间长、种类多及中心静脉置管是C0PD患者继发真菌感染主要危险因素。更多还原

【Abstract】 Objective To investigate the risk factors of acquired pulmonary fungal infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Clinical data of 794 hospitalized patients with AECOPD from January to December 2011 were retrospectively analyzed.The patients divided into acquired fungal infection group(140 cases) and non-secondary fungal infection group(654 cases).Single factor and multi-factor non-conditional logistic regression analysis were used to analyze 20 risk factors of acquired fungal infection.Results Single factor non-conditional logistic regression analysis showed that the history of fungal infection,hypoalbuminemia,respiratory failure,renal insufficiency,hospitalization stay,length of intensive care unit stay,intravenous catheters,nasogastric tube,indwelling of bladder catheters,peripheral intravenous nutrition,non-invasive and invasive mechanical ventilation,duration of hormone application,duration and type of antibiotics were risk factors of secondary fungal infection(P < 0.05).These associated risk factors then entered into multi-factor logistic regression analysis,which showed that the previous history of fungal infection,duration of hormone application > 2 weeks,duration of antibiotic application > 2 weeks,invasive mechanical ventilation,venous catheters and type of antibiotics > 2 were the main risk factors of acquired fungal infection(odds ratio:63.319,3.193,1.691,1.615,2.002,2.040,P<0.05).Conclusion Previous history of fungal infection,long-term application of hormone,application of invasive mechanical ventilation,long-term application of multiple antibiotic and central venous catheter indwelling are the main risk factors of acquired fungal infection in patients with AECOPD.更多还原