老年慢性阻塞性肺疾病继发肺真菌病危险因素临床研究.docVIP

老年慢性阻塞性肺疾病继发肺真菌病危险因素临床研究 　　[摘要] 目的 探讨老年慢性阻塞性肺疾病（简称慢阻肺）继发肺真菌病的危险因素。 方法 回顾性分析我院2010年8月～2014年7月收治的80例慢阻肺继发肺真菌病患者的临床资料为实验组，选取同期未继发肺真菌病的80例老年慢阻肺患者作为对照组，探讨其危险因素。 结果 抗生素应用时间14 d、糖皮质激素应用500 mg、机械通气、合并低白蛋白血症、合并糖尿病是老年慢阻肺继发肺真菌病的独立高危因素。 结论 临床应高度重视老年慢阻肺继发肺真菌病的高危因素，并采取相应的预防控制措施，以减少肺真菌感染的发生。 　　[关键词] 慢阻肺；肺真菌病；危险因素；病例对照 　　[中图分类号] R563 [文献标识码] A [文章编号] 1674-4721（2015）09（b）-0026-03 　　Clinical study of risk factors of secondary pulmonary fungal infection in elderly patients with chronic obstructive pulmonary disease 　　LIU Fu-ping 　　Department of Outpatient，Military Region in Jiangxi Province，Nanchang 330006，China 　　[Abstract] Objective To explore the risk factors of secondary pulmonary fungal infection in elderly patients with chronic obstructive pulmonary disease （COPD）. Methods Clinical data of 80 COPD patients with secondary pulmonary fungal infection from August 2010 to July 2014 of our hospital was analyzed retrospectively and selected as experimental group.And 80 COPD patients with no secondary pulmonary fungal infection at the same time were selected as control group to explore the risk factors. Results The used time of antibiotic more than 14 days，the glucocorticoid used more than 500 mg，mechanical ventilation，combined with low serum albumin，combined with diabetes were independent risk factors of elderly COPD patients secondary pulmonary fungal infection. Conclusion Clinical should attach great importance in risk factors of elderly COPD patients with secondary pulmonary fungal infection，and take the corresponding prevention and control measures to reduce the occurrence of pulmonary fungal infection. 　　[Key words] Chronic obstructive pulmonary disease；Pulmonary fungal infection；Risk factor；Case-control 　　慢性阻塞性肺疾病（简称慢阻肺）为呼吸系统常见病及多发病，以不完全可逆性气流受限为主要特征，临床主要表现为咳嗽、咳痰、气喘等。慢阻肺病变主要累及肺，死亡率较高，位居世界死亡病因第4位，对患者的生命安全构成严重威胁[1-2]。老年慢阻肺患者由于免疫功能低下，身体各器官功能衰退，肺组织易受外界侵袭，加之治疗过程中长期应用广谱抗生素、糖皮质激素及机械通气等，慢阻肺继发肺真菌感染的比例不断上升，导致病情加重，是老年慢阻肺患者死亡的主要原因[3]。故有效防止和减少肺部真菌感染的发生是临床关注的重点[4-5]。本研究通过对老年慢阻肺继发肺真菌病和