慢性阻塞性肺疾病急性加重期白色念珠菌感染临床分析(1)

http://www.100md.com 2010年7月1日 段玉香 赵美华 高中度

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     【摘要】 目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)肺部白色念珠菌感染的易患因素、和治疗。方法 本文收集我科2007年1月至2009年12月住院治疗的 AECOPD合并肺部真菌感染及未肺部真菌感染病例各50例,前者为试验组,后者为对照组,观察两组患者的易患因素和治疗情况。结果

    试验组患者平均年龄66.6岁,75%合并意识障碍,50%血清白蛋白低于28 g/L,75%抗菌素平均使用时间超过14 d,83.3%使用糖皮质激素明显高于对照组。结论 若AECOPD患者合并意识障碍、血清白蛋白低下、抗菌药物使用过长、使用糖皮质激素者则白色念珠菌染机会明显增多,与发病年龄及性别关系不明显,有糖尿病、及心脑血管病、恶性肿瘤及慢性肾功能不全等基础疾病者合并白色念珠菌感染率高。

    【关键词】慢性阻塞性肺疾病;白色念珠菌;感染;危险因素

    Clinical analysis of Candida albicans infection in acute exacerbations of Chronic obstructive pulmonary disease

    DUAN Yu-xiang,ZHAO Mei-hua,GAO Zhong-du.Tongren Hospital of Changning District,Shanghai 200050,China

    【Abstract】 Objective Tofindoutthe risk factorsin lung infection,clinical features and therapeutic of candida albicans infection in acute exacerbations of chronic obstructive pulmonary disease.Methods 50 cases of AECOPD with Candida albicans infection were retrospectively analyzed,comparing with 50 cases without fungal infection.The risk factorsin lung infection,clinical features and therapeutic ofCandida albicans infection were analyzed and calculated.The former for the test group,the latter as a control group.Results The average age of the patients in the test group,was 66.6 years old,75%of total cases were in the merger of consciousness,serum albumin lower than 28 g/L(50%),average usage time of antibiotics more than 14 days(75%),glucocorticoid was used significantly higher than control group(83.3%).Conclusion If the merger of consciousness,low serum albumin,antimicrobial drug use is too long,the glucocorticoids used in patients with AECOPD,candida albicans infection were increased,but the age and sex had no impaction obviously.The patients with basic diseases such as diabetes,cardiovascular and cerebrovascular disease,cancer,m alignancy or chronic renal insufficiency were combined with high rates of candida albicans infection.

    【Key words】Chronic obstructive pulmonary disease; Candida albicans; Infection; Risk factors

    慢性阻塞性肺疾病(COPD)是一种以气流受限为特征的疾病。在我国北方地区的发生率及病死率均较高。吸烟是COPD最主要的危险因素,而呼吸道感染则是使COPD加重、恶化的另一重要因素。慢性阻塞性肺疾病急性加重期(AECOPD)最常见病因是细菌、病毒、支原体等,超广谱β-内酰胺酶(ES-BLs)和AmpC β-内酰胺酶的产生,愈加使感染难以控制,严重威胁着人类的健康^[1] ......

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