目的 探討COPD 患者痰真菌培養(yǎng)陽(yáng)性的危險(xiǎn)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(jìn)行回顧性分析。結(jié)果 共收集到78 例患者, 以痰真菌培養(yǎng)結(jié)果分組, 痰真菌培養(yǎng)陽(yáng)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(jì)口服皮質(zhì)激素及皮質(zhì)激素吸入史方面差異無(wú)統(tǒng)計(jì)學(xué)意義( P gt;0. 05) , 在抗生素使用種類、使用時(shí)間、累計(jì)靜脈使用皮質(zhì)激素劑量和使用時(shí)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(zhì)激素使用時(shí)間長(zhǎng)及皮質(zhì)激素靜脈使用劑量大是痰真菌培養(yǎng)陽(yáng)性的危險(xiǎn)因素( P lt;0. 05) 。結(jié)論 長(zhǎng)期大量皮質(zhì)激素的使用, 長(zhǎng)期應(yīng)用多種廣譜抗生素是COPD 患者下呼吸道真菌定植的危險(xiǎn)因素。
引用本文： 祁卉卉,謝國(guó)鋼,金先橋. COPD 患者痰真菌培養(yǎng)陽(yáng)性的相關(guān)因素. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010, 9(6): 591-594. doi: 復(fù)制
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| 3. | 高福生, 龍飛, 祁卉卉, 等. 反復(fù)吸入煙曲霉孢子對(duì)慢性阻塞性肺疾病大鼠氣道炎癥和重構(gòu)的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 7 : 205-209, 222 . |
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| 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(yáng)松云, 等. 非中性粒細(xì)胞缺乏患者發(fā)生侵襲性曲霉病的危險(xiǎn)因素、臨床特征及預(yù)后分析. 中國(guó)呼吸與危重監(jiān)護(hù)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(jìn)展. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2007, 6: 413-415.
- 2. 祁卉卉, 謝國(guó)鋼, 高福生, 等. COPD 并發(fā)持續(xù)喘息與痰真菌培養(yǎng)陽(yáng)性的相關(guān)分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8 : 114-116.
- 3. 高福生, 龍飛, 祁卉卉, 等. 反復(fù)吸入煙曲霉孢子對(duì)慢性阻塞性肺疾病大鼠氣道炎癥和重構(gòu)的影響. 中國(guó)呼吸與危重監(jiān)護(hù)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(yáng)松云, 等. 非中性粒細(xì)胞缺乏患者發(fā)生侵襲性曲霉病的危險(xiǎn)因素、臨床特征及預(yù)后分析. 中國(guó)呼吸與危重監(jiān)護(hù)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 .