中国真菌学杂志2025，Vol.20Issue(6)：631-637,7.DOI:10.3969/j.issn.1673-3827.2025.06.012
深静脉置管血液透析患者继发真菌感染的相关危险因素与预测模型建立
The related risk factors and prediction model establishment of secondary fungal infection in hemodialysis patients with deep venous catheterization
摘要
Abstract
Objective To explore the related influencing factors of secondary fungal infection in hemodialysis(HD)patients with deep venous catheterization and to construct a prediction model.Methods From January 2020 to June 2024,31 patients with fungal infection secondary to deep vein catheterization HD in the blood purification center of the Department of Nephrology,the First Affiliated Hospital of Air Force Medical University were included as the experimental group,and 93 patients who received deep vein catheterization HD at the same time were randomly selected as the control group according to the ratio of 1∶3.The clinical data of the two groups were collected.Logistic regression was used to analyze the risk factors of fungal infection secondary to deep vein catheterization HD.The receiver operating characteristic curve(ROC)was constructed by the probability value fitted by the regression equation.Results Among the 31 patients with fungal infection secondary to deep venous catheterization HD,31 strains of fungi were isolated and cultured,mainly Candida albicans and Aspergillus fumigatus,accounting for 41.94%and 16.13%,respectively.Multivariate logistic regression showed that age(OR=1.167),diabetes(OR=0.114),APACHE Ⅱ score(OR=1.378),catheter indwelling time(OR=1.870),and antibiotic use time(OR=1.346)were independent risk factors for fungal infection secondary to deep vein catheterization HD(P＜0.05).ALB(OR=0.882)was a protective factor for fungal infection secondary to deep vein catheterization HD(P＜0.05).ROC analysis showed that there were statistically significant differences in age,diabetes,APACHE Ⅱ score,catheter indwelling time,antibiotic use time,ALB and combined prediction of fungal infection secondary to deep venous catheterization HD(P＜0.05).Among them,AUC=0.953,95%CI was 0.918-0.989,sensitivity was 0.871,specificity was 0.914,and the predictive value was high.Conclusion Advanced age,diabetes,high APACHE Ⅱ score,long-term catheter indwelling,and antibiotic use time are independent risk factors for fungal infection secondary to deep vein catheterization HD,and ALB is its protective factor.Therefore,precise preventive measures should be implemented for the above factors.关键词
深静脉置管/血液透析/真菌感染/危险因素/预测模型/重症监护Key words
deep venous catheterization/hemodialysis/fungal infection/risk factors/prediction model/intensive care引用本文复制引用
边雪燕,董娟娟,李亚娟..深静脉置管血液透析患者继发真菌感染的相关危险因素与预测模型建立[J].中国真菌学杂志,2025,20(6):631-637,7.基金项目
空军军医大学第一附属医院多学科综合诊疗项目(XJZT18MDT17) （XJZT18MDT17）
