目的分析间质性肺炎患者合并侵袭性肺曲霉病(IPA)的发病危险因素。方法收集自2010年12月至2015年8月我院770例间质性肺炎患者的临床资料,其中合并IPA者46例,对照组未合并IPA者724例。对两组病例的临床资料进行对比,分析间质性肺炎合并IPA发生的危险因素。结果单因素分析显示,两组在年龄(t=3.348,P=0.001)、血清白蛋白水平(t=8.381,P<0.001)、3个月内使用过广谱抗生素(X~2=87.157,P<0.001)、长期使用糖皮质激素(X~2=57.462,P<0.001)、长期使用免疫抑制剂(X~2=31.715,P<0.001)、影像学呈UIP型(X~2=20.632,P<0.001)、糖尿病(X~2=9.737,P=0.002)、心功能衰竭(X~2=9.300,P=0.002)等方面差异有统计学意义。Logistic多因素回归分析显示3个月内使用过广谱抗生素(OR=4.773,P<0.001)、长期使用糖皮质激素(OR=9.195,P<0.001)、长期使用免疫抑制剂(OR=2.662,P=0.046)、影像学呈UIP型(OR=5.725,P<0.001)、糖尿病(OR=3.847,P=0.003)是间质性肺炎合并IPA的危险因素,血清白蛋白水平(OR=0.792,P<0.001)与IPA的发生呈负相关。结论多种因素影响间质性肺炎合并IPA的发生,应采取多种针对性措施,降低该病的发生率。 Objective To analyze the risk factors of invasive pulmonary aspergillosis (IPA) in patients with interstitial pneumonia. Methods Clinical data of 770 patients with interstitial pneumonia in our hospital from December 2010 to August 2015 were collected, including 46 patients with IPA and 724 patients without IPA in the control group. The clinical data of two groups of patients were compared to analyze the risk factors of interstitial pneumonia with IPA. Results Univariate analysis showed that the serum albumin level (t = 8.381, P <0.001) and the broad-spectrum antibiotics (X 2 = 87.157, Long-term use of immunosuppressive agents (X ~ 2 = 31.715, P <0.001), long-term use of glucocorticoid (X ~ 2 = 57.462, P <0.001) , P <0.001), diabetes (X ~ 2 = 9.737, P = 0.002), heart failure (X ~ 2 = 9.300, P = 0.002) and so on. Logistic regression analysis showed that long-term use of broad-spectrum antibiotics (OR = 4.773, P <0.001), long-term use of glucocorticoids (OR = 9.195, (OR = 3.847, P = 0.003) were the risk factors of interstitial pneumonia complicated with IPA, the level of serum albumin (OR = 0.792, P <0.001) was negatively correlated with the occurrence of IPA. Conclusion A variety of factors affect the occurrence of interstitial pneumonia with IPA, we should take a variety of targeted measures to reduce the incidence of the disease.