摘要
目的分析老年慢性阻塞性肺疾病(COPD)患者发生下呼吸道真菌感染的临床特点、病情严重程度及其与住院期间死亡危险性关系。方法选择2011年1月-2013年1月收治79例年龄≥65岁的COPD住院患者,36例COPD发生下呼吸道真菌感染患者为感染组,43例未发生下呼吸道真菌感染患者为对照组,比较两组基础资料、实验室检查、抗菌药物及激素使用、呼吸机辅助通气、住院时间及转归情况;所有数据均使用SPSS18.0软件进行统计分析。结果老年COPD住院患者长期卧床及各种侵入性操作吸痰、机械通气、留置尿管的分布率,感染组分别为47.22%、52.78%、16.13%、41.67%;对照组分别为18.60%、18.60%、2.32%、18.60%,感染组明显高于对照组,差异有统计学意义(P<0.05);感染组pH值、血红蛋白、血清白蛋白均低于对照组,差异有统计学意义(P<0.05),二氧化碳分压、糖化血红蛋白、降钙素原、血沉、超敏C-反应蛋白均高于对照组,差异有统计学意义(P<0.05);感染组抗菌药物种类、激素与呼吸机辅助通气使用率均多于对照组;感染组住院时间明显长于对照组,并发症多于对照组,好转出院率略低于对照组。结论对老年COPD患者应早期诊断真菌感染,减少侵入性操作,积极控制感染,改善营养状态,改善预后。
OBJECTIVE To analyze the clinical features of elderly patients with chronic obstructive pulmonary disease（COPD） complicated with lower respiratory tract fungal infections and observe the correlation between the severity of diseases and the risk of death during hospital stay. METHODS A total of 79 COPD patients aged no less than 65 years, who were hospitalized from Jan 2011 to Jan 2013, were enrolled in the study, the 36 COPD patients with lower respiratory tract infections were assigned as the infection group, the 43 patients without lower respiratory tract fungal infections were set as the control group, then the baseline data, laboratory examination, use of antibiotics or hormones, mechanical ventilation, hospitalization duration, and prognosis were observed and compared between the two groups, and all the data were statistically analyzed with the use of SPSS 18.0 software. RESULTS Of the elderly patients with COPD, the patients with long bedridden time accounted for 47.22% in the infection group, lg. 60% in the control group; the patients who underwent suct^oning accounted for 52.78% in the infection group, 18. 60% in the control group; the patients who underwent mechanical ventilation accounted for 16.13% in the infection group , 2.32% in the control group ; the patients with catheter indwelling accounted for 41.67% in the infection group, 18.60% in the control group, the infection group was significantly higher than the control group, the difference was significant（P〈0.05） ;the pH value , level of hemoglobin, and level of albumin of the infection group were lower than those of the control group, with statistical significance （P〈0.05） ; the partial pressure of carbon dioxide, level of glycosylated hemoglobin, level of procalcitonin, erythrocyte sedimenta tion rate, and level of high sensitivity C reactive protein of the infection group were significanthy higher than those of the control group （P〈0.05） ; the utilization rates of antibiotics, hormones, and ventilator of the infection group
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第6期1397-1399,共3页
Chinese Journal of Nosocomiology
基金
北京市保健科研基金项目(京13-08)
北京市委重大基金资助项目(D121100004912001)
关键词
慢性阻塞性肺疾病
真菌感染
临床分析
Chronic obstructive pulmonary disease
Fungal infection
Clinical analysis
