摘要
目的总结重症肺炎合并侵袭性肺曲霉菌病(IPA)的临床特点,为早期诊断及治疗提供依据。方法分析2005年1月-2011年9月呼吸科病房及呼吸重症监护病房重症肺炎合并侵袭性肺曲霉菌病的31例患者临床资料,同时随机抽取同一时期重症肺炎未并发曲霉菌属感染的32例作为对照组,用SPSS13.0统计软件进行统计处理。结果曲霉菌属的感染与住院天数、是否合并基础疾病、使用广谱抗菌药物及皮质激素相关,与是否进行有创机械通气差异无统计学意义;重症肺炎并侵袭性肺曲霉菌病组感染性休克18例,感染率为58.06%;重症肺炎未发曲霉菌属感染组感染性休克7例,感染率21.88%,差异有统计学意义(P<0.05);曲霉菌属感染患者临床资料中,再次出现发热,体温>38℃24例,占77.4%,呼吸困难加重23例,占74.2%。结论重症肺炎合并曲霉菌属感染预后差,根据宿主因素、病原菌培养及影像表现可早期诊断,经验或抢先治疗,改善患者预后。
OBJECTIVE To study the clinical features of invasive pulmonary aspergillosis （IPA） in patients with severe pneumonia so as to provide evidence for early diagnosis and treatment of this disease. METHODS The clinical data of 31 patients with severe pneumonia and secondary IPA between Jan 2005 and Sep 2011 in the respiratory wards and R-ICU were analyzed. At the same time, 32 severe pneumonia patients without complicating Aspergillus infections were randomly selected as the control group. The statistical analysis was performed with SPSS 13.0 software, RESULTS The Aspergillus infections were related to the hospital stay, underlying diseases, use of broad-spectrum antibiotics and glucocorticoids and were not related to the invasive mechanical ventilation. Of those severe pneumonia patients with infections, there were 24 （77.4%） patients to whom the fever occurred again and 23 （74. 2%） patients with exacerbated dyspnea. CONCLUSION The patients with IPA and severe pneumonia have a poor prognosis. Early diagnosis and empirical antifungal treatment based on the clinical features, pathogen culture and image manifestation may improve the outcome.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第11期2547-2549,共3页
Chinese Journal of Nosocomiology
关键词
重症肺炎
肺曲霉菌病
医院感染
Severe pneumonia
Pulmonary aspergillosis
Nosocomial infection
