目的 探討COPD 患者痰真菌培養(yǎng)陽性的危險因素。方法 收集2005 年1 月至2007年12 月期間于上海市第一人民醫(yī)院、中山醫(yī)院及華東醫(yī)院呼吸科住院的COPD 急性加重期患者的病史資料進行回顧性分析。結果 共收集到78 例患者, 以痰真菌培養(yǎng)結果分組, 痰真菌培養(yǎng)陽性組與陰性組在性別、年齡、糖尿病史、吸煙史、霧化吸入史、累計口服皮質激素及皮質激素吸入史方面差異無統(tǒng)計學意義( P gt;0. 05) , 在抗生素使用種類、使用時間、累計靜脈使用皮質激素劑量和使用時間等方面差異顯著( P lt;0. 01) 。多因素分析提示抗生素和皮質激素使用時間長及皮質激素靜脈使用劑量大是痰真菌培養(yǎng)陽性的危險因素( P lt;0. 05) 。結論 長期大量皮質激素的使用, 長期應用多種廣譜抗生素是COPD 患者下呼吸道真菌定植的危險因素。
引用本文： 祁卉卉,謝國鋼,金先橋. COPD 患者痰真菌培養(yǎng)陽性的相關因素. 中國呼吸與危重監(jiān)護雜志, 2010, 9(6): 591-594. doi: 復制
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| 2. | 祁卉卉, 謝國鋼, 高福生, 等. COPD 并發(fā)持續(xù)喘息與痰真菌培養(yǎng)陽性的相關分析. 中國呼吸與危重監(jiān)護雜志, 2009, 8 : 114-116. |
| 3. | 高福生, 龍飛, 祁卉卉, 等. 反復吸入煙曲霉孢子對慢性阻塞性肺疾病大鼠氣道炎癥和重構的影響. 中國呼吸與危重監(jiān)護雜志, 2008, 7 : 205-209, 222 . |
| 4. | Ader F, Nseir S, Guery B, et al. Acute invasive pulmonary aspergillosis in chronic lung disease--a review. Rev Mal Respir,2006, 23( 3 Suppl) : S11-S20. |
| 5. | Muquim A, Dial S, Menzies D. Invasive aspergillosis in patients with chronic obstructive pulmonary diseases. Can Respir J, 2005, 12 :199 -204. |
| 6. | 陶敏, 熊自忠. 120 例臨床真菌感染的分析. 安徽醫(yī)藥, 2005, 9 :765 . |
| 7. | 陳瑞英, 靳建軍, 歐陽松云, 等. 非中性粒細胞缺乏患者發(fā)生侵襲性曲霉病的危險因素、臨床特征及預后分析. 中國呼吸與危重監(jiān)護雜志, 2008, 7: 169-173. |
| 8. | Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking corticosteroids. Rev Infect Dis, 1989 , 11: 954 -963. |
| 9. | Palmer LB, Greenberg HE, Schiff MJ. Corticosteroid treatment as a risk factor for invasive aspergillosis in patients with lung disease.Thorax, 1991, 46: 15 -20. |
| 10. | Rello J, Esandi ME, Mariscal D, et al. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease:report of eight cases and review. Clin Infect Dis, 1998, 26: 1473 -1475. |
| 11. | Denning DW. Invasive aspergillosis. Clin Infect Dis, 1998, 26: 781 -805. |
| 12. | Roilides E, Uhlig K, Venzon D, et al. revention of corticosteroidinduced suppression of human polymorphonuclear leukocyte-induced damage of Aspergillus fumigatus hyphae by granulocyte colonystimulating factor and [ gamma] interferon. Infect Immun, 1993, 61 :4870-4877. |
| 13. | Roilides E, Blake C, Holmes A, et al. Granulocyte-macrophage colony-stimulating factor and interferon-[ gamma ] prevent dexamethasone-induced imunosuppression of antifungal monocyte activity against Aspergillus fumigatus hyphae. J Med Vet Mycol,1996, 34: 63 -69 . |
- 1. 劉春濤, 馮玉麟. 慢性阻塞性肺疾病急性加重研究進展. 中國呼吸與危重監(jiān)護雜志, 2007, 6: 413-415.
- 2. 祁卉卉, 謝國鋼, 高福生, 等. COPD 并發(fā)持續(xù)喘息與痰真菌培養(yǎng)陽性的相關分析. 中國呼吸與危重監(jiān)護雜志, 2009, 8 : 114-116.
- 3. 高福生, 龍飛, 祁卉卉, 等. 反復吸入煙曲霉孢子對慢性阻塞性肺疾病大鼠氣道炎癥和重構的影響. 中國呼吸與危重監(jiān)護雜志, 2008, 7 : 205-209, 222 .
- 4. Ader F, Nseir S, Guery B, et al. Acute invasive pulmonary aspergillosis in chronic lung disease--a review. Rev Mal Respir,2006, 23( 3 Suppl) : S11-S20.
- 5. Muquim A, Dial S, Menzies D. Invasive aspergillosis in patients with chronic obstructive pulmonary diseases. Can Respir J, 2005, 12 :199 -204.
- 6. 陶敏, 熊自忠. 120 例臨床真菌感染的分析. 安徽醫(yī)藥, 2005, 9 :765 .
- 7. 陳瑞英, 靳建軍, 歐陽松云, 等. 非中性粒細胞缺乏患者發(fā)生侵襲性曲霉病的危險因素、臨床特征及預后分析. 中國呼吸與危重監(jiān)護雜志, 2008, 7: 169-173.
- 8. Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking corticosteroids. Rev Infect Dis, 1989 , 11: 954 -963.
- 9. Palmer LB, Greenberg HE, Schiff MJ. Corticosteroid treatment as a risk factor for invasive aspergillosis in patients with lung disease.Thorax, 1991, 46: 15 -20.
- 10. Rello J, Esandi ME, Mariscal D, et al. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease:report of eight cases and review. Clin Infect Dis, 1998, 26: 1473 -1475.
- 11. Denning DW. Invasive aspergillosis. Clin Infect Dis, 1998, 26: 781 -805.
- 12. Roilides E, Uhlig K, Venzon D, et al. revention of corticosteroidinduced suppression of human polymorphonuclear leukocyte-induced damage of Aspergillus fumigatus hyphae by granulocyte colonystimulating factor and [ gamma] interferon. Infect Immun, 1993, 61 :4870-4877.
- 13. Roilides E, Blake C, Holmes A, et al. Granulocyte-macrophage colony-stimulating factor and interferon-[ gamma ] prevent dexamethasone-induced imunosuppression of antifungal monocyte activity against Aspergillus fumigatus hyphae. J Med Vet Mycol,1996, 34: 63 -69 .