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病毒性肺炎合并侵袭性肺真菌病的危险因素分析OA北大核心CSTPCD

Analysis of risk factors for viral pneumonia combined with invasive pulmonary mycosis

中文摘要英文摘要

目的:探讨病毒性肺炎合并侵袭性肺真菌病(invasive pulmonary mycosis,IPM)发病的相关危险因素.方法:采用回顾性研究方法,选取2021年1月至2023年10月在山东第一医科大学附属中心医院住院的105例诊断为病毒性肺炎合并IPM的患者作为观察组;同时,按照1:1比例选取同时期未合并IPM的病毒性肺炎患者105例作为对照组.收集并分析两组患者的社会人口学特征、临床表现、影像学表现及实验室检查结果等资料,采用logistic回归分析病毒性肺炎患者发生IPM的影响因素.结果:观察组合并糖尿病、有恶性肿瘤病史、有胸腔积液、合并细菌感染,以及血清G试验阳性者分别占51.4%(54/105)、25.7%(27/105)、43.8%(46/105)、36.2%(38/105)、23.8%(25/105),对照组分别占 35.2%(37/105)、6.7%(7/105)、19.0%(20/105)、13.3%(14/105)、2.9%(3/105),差异均有统计学意义(x2=5.604,P=0.018;x2=14.037,P<0.001;x2=14.937,P<0.001;x2=14.722,P<0.001;x2=19.945,P<0.001).多因素 logistic 回归分析显示,合并糖尿病[OR(95%CI):2.452(1.164~5.163)]、有恶性肿瘤病史[OR(95%CI):11.688(3.707~36.847)]、有胸腔积液[OR(95%CI):2.484(1.123~5.494)]、合并细菌感染[OR(95%CI):3.341(1.410~7.920)],以及血清 G 试验阳性[OR(95%CI):13.649(3.267~57.029)]是病毒性肺炎患者并发IPM的独立危险因素.结论:对于确诊为病毒性肺炎的患者,应警惕其中合并糖尿病、有恶性肿瘤病史、有胸腔积液、合并细菌感染、血清G试验阳性者并发IPM的风险.

Objective:To explore the related risk factors for the development of viral pneumonia combined with invasive pulmonary mycosis(IPM).Methods:Using a retrospective study method,105 patients diagnosed with viral pneumonia combined with IPM who were hospitalized at the Affiliated Central Hospital of Shandong First Medical University from January 2021 to October 2023 were selected as the observation group;meanwhile,105 patients with viral pneumonia who did not have IPM during the same period were selected as the control group in a 1∶1 ratio.The sociodemographic characteristics,clinical manifestations,imaging findings,and laboratory test results of the two groups were collected and analyzed.Logistic regression was used to analyze the influencing factors of IPM in patients with viral pneumonia.Results:In the observation group,51.4%(54/105),25.7%(27/105),43.8%(46/105),36.2%(38/105)and 23.8%(25/105)of the patients had diabetes,a history of malignant tumor,pleural effusion,bacterial infection,and a positive serum G test,respectively;In the control group,the corresponding figures were 35.2%(37/105),6.7%(7/105),19.0%(20/105),13.3%(14/105),and 2.9%(3/105)respectively,and the differences were statistically significant(x2=5.604,P=0.018;x2=14.037,P<0.001;x2=14.937,P<0.001;x2=14.722,P<0.001;x2=19.945,P<0.001).Multivariate logistic regression analysis showed that diabetes(OR(95%CI):2.452(1.164-5.163)),history of malignancy(OR(95%CI):11.688(3.707-36.847)),pleural effusion(OR(95%CI):2.484(1.123-5.494)),bacterial infection(OR(95%CI):3.341(1.410-7.920)),and positive serum G test(OR(95%CI):13.649(3.267-57.029))were independent risk factors for the occurrence of IPM in patients with viral pneumonia.Conclusion:For patients diagnosed with viral pneumonia,attention should be paid to the risk of IPM in those with diabetes,a history of malignant tumor,pleural effusion,bacterial infection and a positive serum G test.

柴冬雨;秦淑一;张荣花;邹楠楠;王欣

山东第二医科大学临床医学院,潍坊 261053山东第一医科大学附属中心医院呼吸与危重症医学科,济南 250013

临床医学

肺炎,病毒性肺疾病,真菌性共病现象因素分析,统计学

Pneumonia,viralLung Diseases,fungalComorbidityFactor analysis,statistical

《中国防痨杂志》 2024 (007)

750-755 / 6

山东省医药卫生科技项目(202303021417);山东第一医科大学教育教学改革研究项目基金(XZ2022016) Medical and Health Science and Technology Project of Shandong Province(202303021417);Education and Teaching Reform Research Project of Shandong First Medical University(XZ2022016)

10.19982/j.issn.1000-6621.20240145

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