CAJ | 학술논문

目的：探讨侵袭性真菌感染预后相关的危险因素。方法回顾性分析中山大学孙逸仙纪念医院2007年至2011年出院诊断为侵袭性真菌感染的208例患者的临床资料，对可能影响预后的因素进行单因素及Logistic回归分析。结果本院成年住院患者侵袭性真菌感染的病死率为21.2％。单因素分析显示，患者年龄≥60岁、住院天数、空腹血糖升高、低白蛋白血症、2种及2种以上广谱抗生素应用超过2周、侵入性操作种类、多器官功能障碍综合征等7项指标在两组之间差异有统计学意义（ P ＜0.05）。二分类Logistic回归分析结果显示，≥60岁、低白蛋白血症、侵入性操作种类、2种及2种以上广谱抗生素应用超过2周、多器官功能障碍综合征等5项指标在两组之间差异有统计学意义（ P ＜0.05）。结论≥60岁、低白蛋白血症、侵入性操作种类、2种及2种以上广谱抗生素应用超过2周、多器官功能障碍综合征等5个因素可能是侵袭性真菌感染患者死亡的独立危险因素。在临床诊治中应早期进行医学干预，以降低患者病死率。
목적：탐토침습성진균감염예후상관적위험인소。방법회고성분석중산대학손일선기념의원2007년지2011년출원진단위침습성진균감염적208례환자적림상자료，대가능영향예후적인소진행단인소급Logistic회귀분석。결과본원성년주원환자침습성진균감염적병사솔위21.2％。단인소분석현시，환자년령≥60세、주원천수、공복혈당승고、저백단백혈증、2충급2충이상엄보항생소응용초과2주、침입성조작충류、다기관공능장애종합정등7항지표재량조지간차이유통계학의의（ P ＜0.05）。이분류Logistic회귀분석결과현시，≥60세、저백단백혈증、침입성조작충류、2충급2충이상엄보항생소응용초과2주、다기관공능장애종합정등5항지표재량조지간차이유통계학의의（ P ＜0.05）。결론≥60세、저백단백혈증、침입성조작충류、2충급2충이상엄보항생소응용초과2주、다기관공능장애종합정등5개인소가능시침습성진균감염환자사망적독립위험인소。재림상진치중응조기진행의학간예，이강저환자병사솔。
Objective To explore the risk factors affecting prognosis of invasive fungal infection .Methods The clinical data of 208 hospitalized patients diagnosed with invasive fungal infection in Sun Yat-sen memorial hospital from 2007 to 2011 were reviewed . The factors affecting prognosis were determined by univariate and logistic regression analysis .Results The fatality rate of adult inpa-tient with invasive fungal infection was 21%.The univariate analysis showed that difference of seven indicators was significant between the survive group and death group:advanced age (over 60 years old), hospitalization time,fasting plasma glucose level, hypoalbumin-emia, using more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome ( MODS) .Binary logistic regression showed that the difference of five indicators was significant between the two groups:advanced age (over 60 years old), hypoalbuminemia, using more than two kinds of broad spectrum antibiotic for more than two weeks, kinds of invasive operations , and multiple organ dysfunction syndrome .Conclusions The indicators such as advanced age (over 60 years old), hypoalbuminemia, the use of more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome might be independent risk factors of death in patients with invasive fungal infection.Early medical intervention should be made in clinical work , in order to reduce fatality rate of patients with invasive fungal in-fection.