中国真菌学杂志2025，Vol.20Issue(5)：477-482,6.DOI:10.3969/j.issn.1673-3827.2025.05.006
肝硬化静脉曲张出血内镜治疗后出现真菌感染的易感因素研究
Study onpredisposing factors for fungal infection after endoscopic treatment of variceal bleeding in liver cirrhosis
摘要
Abstract
Objective To investigate the predisposing factors for fungal infections in patients with liver cirrhosis and esophagogastric variceal bleeding(EGVB)after endoscopic treatment.Methods Fifteen patients with cirrhosis who devel-oped fungal infections after endoscopic treatment for esophagogastric variceal bleeding(EGVB)were retrospectively select-ed from the First Affiliated Hospital of Air Force Medical University(January 2019 to September 2024)as the infection group,and 65 patients with cirrhosis who underwent EGVB endoscopic treatment without infections during the same peri-od were randomly selected as the non-infection group.Clinical data from both groups were collected,and multivariate lo-gistic regression analysis was used to identify predisposing factors.The predictive value was assessed using receiver operat-ing characteristic(ROC)curves,and a decision tree model was constructed.Results Among the 15 patients with fungal infections after endoscopic treatment,16 fungal strains were detected,with Candida albicans being the most prevalent(7 strains,43.75%).Additionally,13 strains(81.25%)were isolated from sputum/bronchoalveolar lavage fluid.Logistic regression analysis revealed that age,hospitalization duration,Child-Pugh classification of liver function,hepatic encepha-lopathy,and long-term use of broad-spectrum antibiotics were predisposing factors for fungal infections after endoscopic treatment in EGVB patients(P<0.05),while albumin and serum 25-hydroxyvitamin D3[25-(OH)D3]were protective factors(P<0.05).ROC curve analysis showed that the above indicators and their combined prediction were statistically significant for predicting fungal infections after endoscopic treatment(P<0.05).The combined prediction had an area un-der the curve(AUC)of 0.999(95%CI:0.996～1.000),with a sensitivity of 1.000 and specificity of 0.985,indicating higher predictive value.The decision tree model identified age as the most significant predictor,with a classification accura-cy of 100%.Conclusion Age,hospitalization duration,Child-Pugh classification of liver function,hepatic encephalopathy,and long-term use of broad-spectrum antibiotics are predisposing factors for fungal infections after endoscopic treatment in EGVB patients,while albumin and 25-(OH)D3 are protective factors.Clinicians should assess these related factors and im-plement targeted preventive measures.关键词
肝硬化/食管胃底静脉曲张破裂出血/内镜治疗/真菌感染/易感因素/防护措施Key words
liver cirrhosis/esophagogastric variceal bleeding/endoscopic treatment/fungal infection/predisposing factors/safeguard procedures引用本文复制引用
刘粉霞,郭冠亚,聂燕..肝硬化静脉曲张出血内镜治疗后出现真菌感染的易感因素研究[J].中国真菌学杂志,2025,20(5):477-482,6.基金项目
陕西省重点研发计划项目(2024SF-YBXM-141) （2024SF-YBXM-141）
