CAJ | 학술논문

目的：探讨慢性阻塞性肺疾病（COPD）并发真菌性肺炎与广谱抗菌素使用的关系。方法选择2011年1月至2013年6月住院期间并发真菌性肺炎的COPD患者65例为感染组，以同期无真菌性肺炎的2014例COPD住院患者为对照组，分析COPD并发真菌性肺炎与广谱抗菌素种类和疗程的关系。结果感染组广谱抗菌素使用率及使用疗程均明显高于/长于对照组（P<0.05）。广谱抗菌素使用>21d或联用广谱抗菌素和甲强龙>14d，真菌性肺炎发生率均显著升高（P<0.05），碳青霉烯类抗菌素联用甲强龙>14d患者真菌性肺炎发生率显著高于头孢类抗菌素或酶抑制剂复合制剂联用甲强龙患者（P<0.05）。结论使用广谱抗菌素>21d及联用碳青霉烯类抗菌素和甲强龙>14d是COPD并发真菌性肺炎的独立危险因素。
목적：탐토만성조새성폐질병（COPD）병발진균성폐염여엄보항균소사용적관계。방법선택2011년1월지2013년6월주원기간병발진균성폐염적COPD환자65례위감염조，이동기무진균성폐염적2014례COPD주원환자위대조조，분석COPD병발진균성폐염여엄보항균소충류화료정적관계。결과감염조엄보항균소사용솔급사용료정균명현고우/장우대조조（P<0.05）。엄보항균소사용>21d혹련용엄보항균소화갑강룡>14d，진균성폐염발생솔균현저승고（P<0.05），탄청매희류항균소련용갑강룡>14d환자진균성폐염발생솔현저고우두포류항균소혹매억제제복합제제련용갑강룡환자（P<0.05）。결론사용엄보항균소>21d급련용탄청매희류항균소화갑강룡>14d시COPD병발진균성폐염적독립위험인소。
Objective To explore the relationship between broad-spectrum antibacterials use and nosocomial fungal pneumonia in patients with acute exacerbation of chronic pulmonary obstructive diseases(COPD). Methods Sixty five inpatients with acute exacerbation of COPD complicated by nosocomial fungal pneumonia between January 1,2011,and June 30,2013 were selected as infection group,while the other 2014 cases of COPD inpatients without fungal pneumonia were selected as control group during the same period. The relationship of the nosocomial fungal pneumonia in COPD patients with the kinds and use duration of broad-spectrum antibacterials were analyzed. Results The use rate and mean use duration of broad-spectrum antibacterials in infection group were significantly higher or longer than that in control group (both P<0.05). The incidence of fungal pneumonia in patients with use duration of broad-spectrum antibacterial over 21 days or combined use duration of antibacterial and prednisolone over 14 days was significantly increased (both P<0.05). Patients with combined use of carbapenems and prednisolone had higher incidence of fungal pneumonia than those with use of broad-spectrum cefalosporin or β-lactamase inhibitor compound in combination with prednisolone(P<0.05). Conclusions Longer use durations of broad-spectrum antibacterial,combined use of carbpenems and prednisolone over 14 days might be independent risk factors for the nosocomial fungal pneumonia in in-patients with acute exacerbation of COPD .