發(fā)布時間：2018-03-02 14:03

  本文選題：慢性阻塞性肺疾病　切入點(diǎn)：侵襲性肺曲霉菌病　出處：《新疆醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：慢性阻塞性肺疾病(COPD)病人中并發(fā)侵襲性肺曲霉菌病(IPA)在逐年增多，但是鑒于IPA的臨床癥狀不典型性，臨床上很難早期診斷。本研究旨在分析COPD患者并發(fā)IPA的危險因素，以提高COPD患者早期診斷IPA可能。方法：通過病歷系統(tǒng)選取新疆醫(yī)科大學(xué)第一及第二附屬醫(yī)院2011年2月至2012年12月6例確診和8例臨床診斷的共14例COPD伴有IPA患者為病例組，及同年入院、性別相同、年齡及COPD病史基本一致的14例COPD患者作為對照組，于配比后進(jìn)行病例對照研究，應(yīng)用SPSS19.0軟件單因素分析各項因素(包括宿主因素、臨床癥狀、體征、實驗室檢查結(jié)果及診療經(jīng)過)在COPD患者中發(fā)生IPA的作用。結(jié)果：通過單因素分析發(fā)現(xiàn)：吸煙史(2年，P=0.018)，血清白蛋白減低(35g/L，P=0.001)，既往住院天數(shù)(P=0.006)，轉(zhuǎn)入ICU并伴有機(jī)械通氣(P=0.013)四個因素是COPD病人發(fā)生IPA的主要危險因素。結(jié)論：COPD病人伴有長期吸煙史、血清白蛋白減低、既往住院天數(shù)較長、伴有入住ICU及機(jī)械通氣史的患者較易發(fā)生IPA，鑒于臨床上IPA發(fā)病率逐年升高及其很高的死亡率，發(fā)現(xiàn)COPD病人伴有以上幾種危險因素時，，需提高警惕。
[Abstract]:Objective: the incidence of invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease (COPD) is increasing year by year, but in view of the atypical clinical symptoms of IPA, it is difficult to diagnose it early. This study was designed to analyze the risk factors of IPA in patients with COPD. In order to improve the possibility of early diagnosis of IPA in patients with COPD, 14 cases of COPD with IPA were selected from the first and second affiliated hospitals of Xinjiang Medical University from February 2011 to December 6th 2012 and 8 cases of clinical diagnosis from February 2011 to December 6th 2012. In the same year, 14 COPD patients with the same sex, same age and similar history of COPD were used as the control group. A case-control study was carried out after matching. The factors (including host factors, clinical symptoms, signs) were analyzed by SPSS19.0 software. Results: the role of IPA in COPD patients was found by univariate analysis. Results: smoking history was found by univariate analysis (2 years P0. 018, serum albumin decreased 35 g / L P0. 001, previous hospitalization days were P0. 006, ICU was transferred to ICU with mechanical ventilation P0. 013). Four factors are the main risk factors for developing IPA in COPD patients. Conclusion the patients with COPD have a long history of smoking. The patients with ICU and mechanical ventilation were more likely to develop IPA. In view of the increasing incidence of IPA and its high mortality rate in clinic, it was found that the patients with COPD were accompanied by the above risk factors. Vigilance is needed.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.9

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