目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者并发真菌性肺炎的危险因素。方法 选取汉中中航工业3201医院自2012年12月—2014年6月收住入院的80例AECOPD并发真菌性肺炎患者为感染组, 选取同期入院的无真菌感染的住院患者94例作为对照组, 分析AECOPD患者并发真菌性肺炎的危险因素。结果 两组年龄、性别、体重指数(BMI)、呼吸衰竭发生人数比较, 差异无统计学意义(P>0.05)。两组在吸烟人数、患有糖尿病人数、广谱抗生素使用时间、激素使用时间、ALB、机械通气人数、呼吸衰竭发生情况、APACHE-II评分方面差异具有显著性(P<0.05)。根据单因素分析结果, 将P<0.05指标纳入多元logistic回归分析, 结果显示长期应用广谱抗生素和激素、低蛋白血症、吸烟、高APACHE-II评分是AECOPD患者并发真菌性肺炎发生的独立危险因素(P<0.05)。结论 广谱抗生素使用时间长、激素使用时间长、ALB较低、吸烟、APACHE-II评分较高的AECOPD患者较易发生真菌性肺炎。

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.