真菌致呼吸机相关性肺炎的危险因素分析

目的：探讨真菌致呼吸机相关性肺炎的危险因素。方法：回顾性分析本院RICU和ICU2009年至2012年呼吸机相关性肺炎患者98例的临床资料，分为真菌性呼吸机相关性肺炎（FVAP）组和非真菌性呼吸机相关性肺炎（NFVAP）组，比较两组真菌感染的易患因素，采用单因素G（2检验）及多因素Logistic回归进行统计学分析。结果：急性生理学及慢性健康状况评分（APACHEII）、使用MV时间（〉7d）、住院时间（〉15d）、血白蛋白〈25g、合并糖尿病、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的危险因素，其中血白蛋白〈25g、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的独立危险因素。结论：患者血白蛋白〈25g、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的独立危险因素。

Analysis of the Risk Factors of Ventilator-associated Pneumonia Caused by Fungi

Objective： To investigate the risk factors of ventilator associated pneumonia （VAP） caused by fungal. Methods： A retrospective analysis was performed on 98 cases of VAP in the ICU and RICU of our hospital from 2009 to 2012. The patients were randomly divided into the fungal ventilator associated pneumonia（FVAP） group and nonfungal ventilator associated pneumonia（NFVAP） group. The risk factors were analyzed by univariate analysis and multivariate logistic regression analysis. Results： Univariate analysis showed that APACHEII scores, using time of MV （〉7d）, hospital stay （〉 15d）, diabetes, frequent changes of antibiotics, the combined drug abuse of antibiotics and blood albumin （〈25 g） were the risk factors of FVAP; while frequent changes of antibiotics, the combined drug abuse of antibiotics and blood albumin （〈25 g） were the independent risk factors of FVAP. Conclusion： Frequent changes of antibiotics, the combined drug abuse of antibiotics and blood albumin （〈25 g） were the independent risk factors of FVAP, which needed to be payed attention in clinic.