肝脏 ›› 2020, Vol. 25 ›› Issue (7): 714-716.

• 肝硬化 • 上一篇    下一篇

白色假丝酵母菌在肝硬化患者中定植水平及其高危因素分析

刘妲妲, 梁栋, 朱晓红, 张燕, 董晓锋, 王全楚   

  1. 450042 河南郑州 中国人民解放军联勤保障部队第九八八医院感染科
  • 收稿日期:2019-09-21 发布日期:2020-08-06

Risk factors for the colonization of Candida Albicans in patients with liver cirrhosis

LIU Da-da, LIANG Dong, ZHU Xiao-hong, ZHANG Yan, DONG Xiao-feng, WANG Quan-chu   

  1. Department of Infectious Diseases, 988 Hospital of the People′s Liberation Army Joint Service Support Force, Zhengzhou 450042, China
  • Received:2019-09-21 Published:2020-08-06

摘要: 目的: 研究肝硬化患者并发感染后机体内白色假丝酵母菌定植水平及其高危因素。方法: 选取2016年3月—2019年1月我院收治肝硬化患者作为观察组(n=103),另选择同期来院体检合格健康者作为对照组(n=103)。分别采集观察组患者粪便、痰液标本,采集对照组粪便、痰液标本,进行微生物培养。观察两组粪便、痰液标本中各类型真菌定植水平。采通过logistic回归分析法对肝硬化患者感染白色假丝酵母菌危险因素进行分析。结果: 观察组粪便与痰液中白色假丝酵母菌分布比例均显著高于对照组(P<0.05);观察组粪便与痰液中白色假丝酵母菌分布比例明显高于本组光滑念珠菌、克柔假丝酵母菌及其他真菌(P<0.05)。logistic回归分析显示,住院天数≥14 d、肝功能Child-Pugh分级B或C级及血清白蛋白≤25 g/L均是观察组患者感染白色假丝酵母菌的高危因素(P<0.05)。结论: 白色假丝酵母菌是肝硬化真菌感染患者消化道、呼吸道中定植的主要真菌。住院天数≥14 d、肝功能Child-Pugh分级B或C级及血清白蛋白≤25 g/L均可作为肝硬化患者感染白色假丝酵母菌的高危因素,对存在高危因素患者,临床应及时做出应对措施,以避免影响患者预后。

关键词: 白色假丝酵母菌, 肝硬化, 定植水平, 高危因素

Abstract: Objective To investigate the colonization of Candida albicans in patients with liver cirrhosis and the risk factors. Methods 103 patients with liver cirrhosis in the observation group and 103 healthy physical examinees in the control group who visited 988 Hospital of the People's Liberation Army from March 2016 to January 2019 were enrolled. Specimens of feces and sputum were collected separately from both groups for microbial culture to observe the colonization levels of various types of fungi in the specimens. The risk factors of Candida albicans infection in liver cirrhotic patients were further analyzed by logistic regression analysis. Results The distribution ratios of Candida albicans in the feces and sputum of the observation group were significantly higher than the control group (P<0.05). In the observation group, the distribution ratios of Candida albicans in feces and sputum were significantly higher than those of Candida glabrata, Candida krusei and other fungi (P<0.05). Logistic regression analysis showed that hospitalization days ≥14 d, Child-Pugh of grade B or C and serum albumin ≤25 g/L were risk factors for Candida albicans infection (P<0.05). Conclusion Candida albicans is the main fungus colonized in the digestive tract and respiratory tract of cirrhotic patients with fungal infection. Hospitalization days ≥14 d, Child-Pugh grade B or C and serum albumin ≤25 g/L are risk factors for the infection. Countermeasures should be taken to improve the prognosis of the patients.

Key words: Candida albicans, Liver cirrhosis, Colonization, Risk factors