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目的探讨慢性阻塞性肺疾病(COPD)呼吸衰竭合并肺部真菌感染患者预后的影响因素。方法选取南宁市第八人民医院2013年5月—2015年6月诊治的COPD呼吸衰竭合并肺部真菌感染后死亡患者45例作为观察组,选取同期COPD呼吸衰竭合并肺部感染未死亡患者45例作为对照组,采取单因素Logistic回归和多因素Logistic回归分析筛选COPD呼吸衰竭合并肺部真菌感染患者预后的影响因素。结果单因素Logistic回归分析结果显示,年龄、病程、机械通气、吸烟、两种及以上器官功能衰竭、两种及以上真菌感染、抗生素联合应用和低蛋白血症与COPD呼吸衰竭合并肺部真菌感染患者预后有关(P<0.05);多因素Logistic回归分析结果显示,病程、两种及以上器官功能衰竭、抗生素联合应用以及低蛋白血症与COPD呼吸衰竭合并肺部真菌感染患者预后有关(P<0.05)。结论病程迁延、两种及以上器官功能衰竭和低蛋白血症为COPD呼吸衰竭合并肺部真菌感染患者死亡的危险因素,而抗生素联合应用为保护因素,早期预防控制上述危险因素可降低病死率,改善患者预后。
Objective To investigate the influencing factors of the prognosis of patients with chronic obstructive pulmonary disease (COPD) respiratory failure and pulmonary fungal infection. Methods Forty-five patients died of COPD respiratory failure and pulmonary fungal infection from May 2013 to June 2015 in Nanning Eighth People’s Hospital were selected as the observation group. Forty-five patients with COPD respiratory failure who did not die from pulmonary infection As a control group, single factor Logistic regression and multivariate Logistic regression analysis were used to screen the prognostic factors of COPD patients with pulmonary fungal infection. Results The results of univariate Logistic regression analysis showed that age, duration of disease, mechanical ventilation, smoking, two or more organ failure, two or more fungal infections, combination of antibiotics and hypoproteinemia and COPD respiratory failure with pulmonary fungal infection (P <0.05). Multivariate logistic regression analysis showed that the duration of disease, the combination of two or more organ failure, combination of antibiotics and hypoproteinemia were associated with the prognosis of COPD patients with pulmonary fungal infection (P < 0.05). Conclusions Duration of disease, two or more organ failure and hypoproteinemia are risk factors for mortality in patients with COPD respiratory failure and pulmonary fungal infection. Antibiotics combined with antibiotics may be the protective factor. Early prevention and control of the above risk factors may reduce mortality, Improve patient’s prognosis.