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目的分析慢性阻塞性肺疾病(COPD)患者院内肺部真菌感染的危险因素。方法采用病例对照研究方法,收集2000-01～2003-06在重庆医科大学附属第一医院肺科住院期间院内肺部真菌感染的COPD患者44例,并随机选择同期住院的无肺部真菌感染COPD患者44例作为对照,采用单因素(t检验,χ2检验)及多因素Logistic回归进行分析。结果对44例COPD患者院内肺部真菌感染单因素分析发现,下列因素与COPD患者院内肺部真菌感染有关长期使用广谱抗生素,长期使用糖皮质激素,低蛋白血症,机械通气,合并糖尿病,合并Ⅱ型呼吸衰竭。但多因素Logistic回归分析确定了4项独立危险因素长期使用广谱抗生素,低蛋白血症,机械通气,合并糖尿病。结论长期使用广谱抗生素,低蛋白血症,机械通气,合并糖尿病是COPD患者院内肺部真菌感染的危险因素。
Objective To analyze the risk factors of nosocomial pulmonary fungal infection in patients with chronic obstructive pulmonary disease (COPD). Methods A case-control study was conducted to collect 44 COPD patients with nosocomial pulmonary fungal infection in the First Affiliated Hospital of Chongqing Medical University from January 2000 to June 2003. COPD patients without hospital-acquired pulmonary fungal infection 44 patients as control, using single factor (t test, χ2 test) and multivariate Logistic regression analysis. Results A single factor analysis of nosocomial pulmonary fungal infection in 44 patients with COPD found that the following factors were associated with long-term use of broad-spectrum antibiotics for pulmonary fungal infections in COPD patients, long-term use of glucocorticoids, hypoproteinemia, mechanical ventilation, diabetes mellitus, Combined type Ⅱ respiratory failure. However, multivariate Logistic regression analysis identified four independent risk factors for long-term use of broad-spectrum antibiotics, hypoproteinemia, mechanical ventilation, and diabetes mellitus. Conclusion Long-term use of broad-spectrum antibiotics, hypoproteinemia, mechanical ventilation, and diabetes mellitus are risk factors for nosocomial pulmonary fungal infection in COPD patients.