摘要
目的:探讨流感相关性曲霉菌病(IAA)患者发病及预后的影响因素,以确定流感感染环境中侵袭性曲霉病的特定危险因素。方法:选取2014年1月1日—2019年12月31日肇庆市第一人民医院收治的383例流感患者作为研究对象,根据其是否患IAA分为病例组(26例)和对照组(357例),比较两组患者的一般情况、发病和预后特征。结果:病例组患者年龄大于对照组患者,差异有统计学意义(t=2.404,P<0.05);病例组患者慢性呼吸道疾病、心血管疾病患病率高于对照组患者,病例组有吸烟史的患者高于对照组患者,差异有统计学意义(χ^(2)=5.093,P<0.05);病例组患者呼吸衰竭、休克、多器官功能障碍综合症(MODS)、并发症发生率高于对照组患者,差异有统计学意义(χ^(2)=19.019、4.014,P<0.05);病例组患者病毒转阴率、治愈率低于对照组患者,差异有统计学意义(χ^(2)=16.780、34.774,P<0.05);病例组患者APACHEⅡ评分高于对照组患者,差异有统计学意义(t=6.552,P<0.05)。吸烟史是IAA发生的独立影响因素,有吸烟的患者比没吸烟的患者容易得IAA。IAA预后影响因素分析显示,死亡组患者吸烟史、并发症、呼吸衰竭、急性生理与慢性健康评分Ⅱ(APACHEⅡ)、心率(HR)、呼吸(R)、降钙素原(PCT)高于生存组患者,淋巴细胞、氧合指数低于生存组患者,差异有统计学意义(t=6.552、3.846、4.624、6.556、7.130、2.521,P<0.05)。结论:吸烟史是IAA发病的独立危险因素,吸烟的流感患者比非吸烟的患者易患IAA。生命体征不稳定、发生并发症、病情危重的IAA患者死亡风险可能更高。
Objective:To investigate the influencing factors of the morbidity and prognosis of patients with influenza-associated aspergillosis(IAA)in order to identify specific risk factors for invasive aspergillosis in the setting of influenza infection.Methods:383 influenza patients admitted to the hospital from January 1,2014 to December 31,2019 were selected as the study subjects,and they were divided into the IAA case group and the non-IAA control group.The general conditions,morbidity and prognostic characteristics of the two groups were compared.Results:The age of the case group was greater than that of the control group,and the difference was statistically significant(t=2.404,P<0.05).The prevalence of chronic respiratory diseases and cardiovascular diseases in the case group was higher than that in the control group,and patients with a history of smoking in the case group was higher than that in the control group,with a statistically significant difference(χ^(2)=5.093,P<0.05).The rates of respiratory failure,shock,MODS,and complications in the case group were higher than those in the control group,and the difference was statistically significant(χ^(2)=19.019,4.014;P<0.05).The viral conversion rate and cure rate of the case group were lower than those of the control group,and the difference was statistically significant(χ^(2)=16.780,34.774;P<0.05).The APACHEⅡscores of the case group were higher than those of the control group,and the difference was statistically significant(t=6.552,P<0.05).Smoking history was an independent influence on the development of IAA,and patients who had smoked were more likely to get IAA than those who had not smoked.The analysis of IAA prognostic influencing factors showed that smoking history,complications,respiratory failure,APACHEⅡscore,HR,R,and PCT were higher in the death group than in the survival group,and lymphocytes and oxygenation index were lower than in the survival group,and the difference was statistically significant(t=6.552,3.846,4.624,6.556,7.130,2.521;P<0.05).Conclusion:Smoking history is an independent risk factor for the development of IAA,and patients with influenza who smoke are more likely to develop IAA than non-smokers.Patients with IAA whose vital signs are unstable,who develop complications,and who are critically ill may have a higher risk of death.
作者
蔡英丽
李仲展
陆广生
李展鹏
张聪
陈晓安
Cai Yingli;Li Zhongzhan;Lu Guangsheng(Emergency Department,ICU,Zhaoqing First People’s Hospital,Zhaoqing,Guangdong,526000,China)
出处
《黑龙江医学》
2024年第7期801-804,共4页
Heilongjiang Medical Journal
基金
肇庆市科技创新市级立项项目(202004030712)。
关键词
流感相关性曲霉菌病
发病
预后
影响因素
病例对照研究
Influenza-associated aspergillosis
Incidence
Prognosis
Influencing factor
Case-control study
