作　　者： (汪艳）; (沈翠芬）; (夏森林）; (谈鹰）; (王东）; (徐鑫）;

机构地区： 浙江省湖州市中心医院,313000

出　　处： 《浙江临床医学》 2017年第10期1915-1916,共2页

摘　　要： 目的分析重症监护病房（ICU）患者发生真菌败血症的临床和微生物特征，并对死亡的危险性进行分析与评估。方法收集2011年1月至2016年1月住院真菌败血症患者的临床资料并进行回顾性分析，分析其基础疾病、真菌的种类、病死率，使用多元回归分析影响预后的危险因素。结果真菌败血症的患者46例，经对死亡组和生存组各项特征的单因素分析及多因素Logisticl回归分析发现，中心静脉导管的留置、免疫抑制剂及激素治疗、APACHEⅡ评分差异均有统计学意义（P〈0．05）。结论ICU患者真菌败血症病死率高，中心静脉导管留置、免疫抑制剂及激素治疗、高APACHEII评分是ICU真菌血症死亡的危险因素。对高危患者应重视病原学检查及药物敏感性测定，消除易患因素，及时合理选用抗真菌药物有望进一步改善预后。 Objective To evaluate mortality prediction by analyzing clinical features and pathogens of patients with fungal septicaemia in intensive care unit （ ICU ） . Methods The clinical data of candidemia cases admitted to ICU of Huzhou Central Hospital from January 2011 to January 2016 were analyzed retrospectively, including risk factors, accompanied diseases, fungus species, mortality and prognosis. Results Forty six cases with fungal septicaemia were diagnosed in recent five years.Single factor Logistic regression analysis combined with multiple conditional Logistic regression model analysis was conducted.Compared to other risk factors, indwelling central venous catheter （ 88.5%vs50.0%, P=0.030, OR=14.46, 95%CI1.29-162.3 ）, hormonotherapy and immunosuppression （69.2%vs20.0%, P=0.032, OR=14.25, 95%CI为1.26-161.5 ）andAPACHEII score （ 20.15± 2.26 ） vs （ 16.70 ± 2.10 ） , P=-0.000, OR=0.49, 95%CI为0.29-0.85 ） were markedly different. Conelusions Fungal septicaemia cases in ICU increases gradually and leads to higher mortality.Indwelling central venous catheter, hormonotherapy, immunosuppression and APACHEII score are related to mortality of fungal septicaemia cases.

关 键 词： 真菌败血症 重症监护病房 死亡 危险因素