目的 探討慢性阻塞性肺疾病急性加重期(AECOPD)患者并發(fā)真菌性肺炎的危險因素。方法 選取漢中中航工業(yè)3201醫(yī)院自2012年12月—2014年6月收住入院的80例AECOPD并發(fā)真菌性肺炎患者為感染組, 選取同期入院的無真菌感染的住院患者94例作為對照組, 分析AECOPD患者并發(fā)真菌性肺炎的危險因素。結(jié)果 兩組年齡、性別、體重指數(shù)(BMI)、呼吸衰竭發(fā)生人數(shù)比較, 差異無統(tǒng)計學(xué)意義(P>0.05)。兩組在吸煙人數(shù)、患有糖尿病人數(shù)、廣譜抗生素使用時間、激素使用時間、ALB、機械通氣人數(shù)、呼吸衰竭發(fā)生情況、APACHE-II評分方面差異具有顯著性(P<0.05)。根據(jù)單因素分析結(jié)果, 將P<0.05指標(biāo)納入多元logistic回歸分析, 結(jié)果顯示長期應(yīng)用廣譜抗生素和激素、低蛋白血癥、吸煙、高APACHE-II評分是AECOPD患者并發(fā)真菌性肺炎發(fā)生的獨立危險因素(P<0.05)。結(jié)論 廣譜抗生素使用時間長、激素使用時間長、ALB較低、吸煙、APACHE-II評分較高的AECOPD患者較易發(fā)生真菌性肺炎。

Objective To explore the risk factors of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients complicated with fungal pneumonia. Methods From December 2012 to June 2014, 80 cases with AECOPD patients complicated with fungal pneumonia in our hospital were selected as observation group, at the same time, 94 patients with no fungal infection were selected as control, the risk factors of AECOPD patients complicated with fungal pneumonia were analyzed. Results The difference of age, sex, BMI, and the number of respiratory failure between the two groups was no statistical significance (P>0.05). The number of smoking, diabetes, and mechanical ventilation, the time of using broad spectrum antibiotic and hormone, ALB, score of APACHE-II between the two groups were observed and the difference was statistical significance (P<0.05). Logistic regression analysis indicated that the long-term usage of broad spectrum antibiotic and hormone, hypoalbuminemia, smoking, high score of APACHE II were the risk factors of AECOPD patients complicated with fungal pneumonia. Conclusion Long-term usage of broad spectrum antibiotic and hormone, lower propagated, smoking, higher APACHE II score in AECOPD patients are prone to fungal pneumonia.