Analysis Of Risk Factors Associated With Invasive Pulmonary Aspergillosis Infections With Chronic Obstructive Pulmonary Diseases

Objective(s):To analyze the clinical data of patients with chronic obstructive pulmonary disease combined with pulmonary aspergillus infection in Yan'an Hospital of Kunming City and discover the related risk factors,which provided a theoretical basis for clinical diagnosis and treatment.Methods:We selected 235 clinical cases diagnosed as COPD from the Department of Respiratory Medicine of Yan'an Hospital,Kunming Medical University from January 2010 to December 2017.Among them,115 cases were observed in the observation group,who had COPD combined with IPA infection,and 120 cases in the control group,who had COPD without IPA infection.Through the comparative study of the above two groups of cases,the risk factors associated with invasive pulmonary aspergillus infection were investigated and statistically analyzed.Results:1.There were 115 patients in the observation group,including 88 males and 27 females,with an average age of(72.14±7.04);120 patients in the control group,including 103 males and 17 females,with an average age of(70.12±9.82).There was no statistical difference in age(P>0.05).There was no significant difference in gender between the two groups(P>0.05).2.The mean length of hospital stay(10.43±1.46)in the observation group was compared with the mean length of stay in the control group(10.07±1.44).There was no statistical difference(P>0.05);the number of years of hospitalization(7.06±2.71)in the observation group was compared with the control group(6.45±2.12).There was no statistical difference(P>0.05).The history of COPD(10.03±3.71)in the observation group was compared with the control group(9.25±2.36).There was no statistical difference(P>0.05).3.Stratified statistical analysis:COPD patients with smoking index>400 were more susceptible to IP A,with statistical differences(P<0.05);C/D COPD patients,hospitalization days>10 days,hospitalization times>7 times/year,Hypoalbuminemia(serum albumin<30g/L),combined use of antibiotics of ?3 species,duration of antibiotic use>10 days,duration of hormone use>14 days,invasive ventilator operation may be risk of COPD and IPA Factors(P<0.05).Age>70 years,history of COPD>10 years,invasive operation(bronchoscopy,deep venous catheterization,catheterization)was not a risk factor for COPD with IPA(P>0.05).4.Multivariate Logistic regression analysis:The independent risk factors for COPD with IPA were:smoking index>400,C/D COPD patients,hypoalbuminemia(serum albumin<30g/L),hospitalization days>10 days The number of hospitalizations was more than 7 times/year,antibiotic types were used in combination with>3,antibiotic use time was>10 days,hormone use time was>14 days,and invasive ventilator operation(P<0.05).Conclusion(s):The combination of COPD and IPA was a multiple factor-mediated affective disease,and there were some correlations between risk factors.That was also a problem with the difficulty of diagnosis and poor treatment.Smoking index>400,C/D class COPD patients,hypoalbuminemia(serum albumin<30g/L),length of hospital stay>10 days,number of hospitalizations>7 times/year,combined use of antibiotics>3 types,antibiotics Use time>10 days,hormone use time>14 days and invasive ventilator operation were high-risk factors for COPD with pulmonary aspergillosis.A more objective understanding of the clinical features and related factors of Aspergillus infection in patients with chronic obstructive pulmonary disease requires a large sample,prospective clinical trials,and basic experimental studies to demonstrate.