摘要
目的研究慢性阻塞性肺疾病(COPD)急性加重期真菌的检出情况与患者病情严重程度及其与患者住院期间死亡危险性的之间关系。方法对2007年7月-2008年6月医院呼吸内科收治的慢性阻塞性肺疾病急性加重的119例患者合格痰标本进行细菌和真菌培养,对真菌培养阳性者做菌丝鉴别和检测药物敏感性;所有患者均进行APACHEⅡ(急性生理和慢性健康估测评分),根据APACHEⅡ积分的结果代入Knaus方程计算出患者住院期间死亡危险性。结果119例患者的痰标本共分离出真菌22株(18.4%),重度COPD患者血气分析呈现显著的呼吸衰竭倾向,真菌的检出率明显高于轻中度COPD患者;APACHEⅡ积分越高的患者真菌的检出率也越高,死亡危险性也越高。结论慢性阻塞性肺疾病急性加重期呼吸道感染仍以细菌为主,但随着住院次数的增多,病情严重度的增加,真菌感染也随着增多,而且真菌感染的患者死亡危险性明显增加。真菌可能是呼吸功能差、病情危重患者的优势菌,在治疗效果差的情况下应该考虑。
OBJECTIVE To investigate pathogenetic condition and fungal detection on evaluating acute exacerbation of COPD （AECOPD）, and the relation of the severity and risk of death during hospital stay. METHODS Samples of sputum, blood and pleural effusion from patients with bronchopulmonary candidiasis in our respiratory department were collected since from Jul 2007 to Jun 2007. All of patients carried out APACHE Ⅱ integrating, aceording to the results of APACHE Ⅱ subset to Knaus equations to calculate the risk of death during hospital stay. RESULTS Twenty-two strains of fungi were isolated from 119 patients（18. 4%）. Blood gas analysis of severe COPD patients indicated a respiratory failure tendency, the fungal detection rate was higher than that of mild or median COPD patients. The higher of APACHE Ⅱ accumulated points, the higher of fungal detection rate, and the higher of risk of death. CONCLUSIONS The most organisms in respiratory tract infection are bacterium. With number of admission times in hospital and severity of pathogenetic condition increased are, the opportunity of fungal infection is raised. Furthermore, the fungal infection associatively with exacerbation. Fungi become the ascendant causative organisms inducing the decrese in pulmonary function and severity of patients, we should think about of it when the therapeutic efficacy is worse.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第16期2099-2101,共3页
Chinese Journal of Nosocomiology
