摘要
目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者下呼吸道标本念珠菌阳性的危险因素,以指导AECOPD的临床救治,减少下呼吸道念珠菌的定植或感染。方法选取民航总医院2016年1月-2018年12月收治的277例AECOPD住院患者为研究对象,以下呼吸道标本念珠菌阳性的168例患者为试验组,下呼吸道标本真菌阴性的109例患者为对照组,收集两组资料,分析影响AECOPD患者下呼吸道念珠菌定植或感染风险的相关危险因素。结果试验组中,念珠菌构成比依次为白色念珠菌(81.55%)、光滑念珠菌(9.52%)、酵母样菌(3.57%)、热带念珠菌(2.98%)、近平滑念珠菌(1.79%)、克柔念珠菌(0.60%)。两组年龄≥70岁、近1年内入院次数>4次、住院时间>30 d、住ICU时间>20 d、吸入LABA、按需吸入SABA、吸入ICS、吸入ICS/LABA、静脉使用糖皮质激素>7 d及抗生素使用>10 d比较,差异有统计学意义(P<0.05);年龄≥70岁、住院时间>30 d、住ICU时间>20 d、按需吸入SABA、吸入ICS、吸入ICS/LABA、静脉使用糖皮质激素>7 d及抗生素使用>10 d为AECOPD患者下呼吸道念珠菌阳性的独立危险因素(P<0.05)。结论在AECOPD患者的临床治疗过程中,应综合考虑患者的年龄、住院和治疗用药情况,及时采取相应的预防措施,尽量减少下呼吸道念珠菌的定植或感染,更好改善患者的预后。
Objective To investigate the risk factors for candida positive in lower respiratory tract specimens of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),so as to guide the clinical treatment of AECOPD and reduce the colonization or infection of candida in lower respiratory tract.Methods A total of 277 AECOPD patients admitted to the Civil Aviation General Hospital from January 2016 to December 2018 were enrolled as research subjects.The clinical data of 168 patients with candida positive in lower respiratory tract specimens as the experimental group,and 109 patients with fungus negative in lower respiratory tract specimens as the control group,general information on the two groups were collected and the risk factors affecting the colonization or infection risk of candida in the lower respiratory tract of patients with AECOPD were analyzed.Results In experimental group,the constituent ratio of candida was candida in turn were candida albicans(81.55%),candida glabrata(9.52%),yeast-like fungi(3.57%),candida tropicalis(2.98%),candida parapsilokis(1.79%),candida krusei(0.60%).There were statistically significant difference in age≥70 years old,number of hospital admissions>4 times in the past year,hospital stays>30 d,ICU time>20 d,inhaled LABA,inhaled SABA on demand,inhaled ICS and ICS/LABA,intravenous corticosteroids>7 d and antibiotic use>10d between the two groups(P<0.05).Age≥70 years old,hospital stays>30 d,ICU time>20 d,inhaled SABA on demand,inhaled ICS,inhaled ICS/LABA,intravenous corticosteroids>7 d and antibiotic use>10 d were the risk factors of candida positive in the lower respiratory tract specimens of patients with AECOPD.Conclusion The treatment for AECOPD should be individualized based upon age,hospitalization and medication,and take corresponding preventive measures in time to reduce the colonization or infection of candida,in order to improve its prognosis.
作者
张黎
刘远程
赵兰兰
ZHANG Li;LIU Yuan-cheng;ZHAO Lan-lan(Health Management Center,Wuzhou Women's and Children's Hospital,Beijing 100122,China;Department of Respiratory Medicine,Civil Aviation General Hospital,Beijing 100123,China)
出处
《医学信息》
2021年第19期92-95,共4页
Journal of Medical Information
关键词
慢性阻塞性肺疾病
AECOPD
下呼吸道标本
念珠菌阳性
Chronic obstructive pulmonary disease
AECOPD
Lower respiratory tract specimens
Candida positive
