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肺结核共感染肺曲霉菌病影响因素单中心分析

Monocentric analysis of risk factors for pulmonary tuberculosis co-infected with pulmonary aspergillosis

    摘要
  • 摘要:
    目的 探讨肺结核共感染肺曲霉菌(PTB-CPA)患者的感染危险因素。
    方法 选取98例肺结核患者为研究对象，根据有无肺曲霉菌感染分为感染组28例和对照组70例。汇集2组临床数据，通过单因素分析鉴别出具有统计学差异的特征因素。
    结果 患者年龄≥60岁(OR=4.056, 95%CI: 1.062~17.037)、男性(OR=0.121, 95%CI: 0.022~0.514)、长期粉尘接触(OR=22.476, 95%CI: 3.966~192.02)、反复应用广谱抗生素(OR=5.372, 95%CI: 1.364~25.957)、合并支气管扩张(OR=6.889, 95%CI: 1.605~34.065)、体质量指数≤22 kg/m2(OR=7.813, 95%CI: 1.735~44.447)是肺结核并发曲霉菌感染的独立危险因素。
    结论 年龄≥60岁、男性、长期粉尘接触、反复应用广谱抗生素、合并支气管扩张、体质量指数≤22 kg/m2的肺结核患者更易感染曲霉菌。构建列线图模型能有效预测发生肺结核共感染肺曲霉菌的风险，识别风险因素有助于提高诊断准确性。

     

    Abstract:
    Objective To investigate the risk factors for pulmonary tuberculosis co-infected with pulmonary aspergillosis (PTB-CPA).
    Methods Ninety-eight pulmonary tuberculosis patients were enrolled and categorized into infection group (n=28) and control group (n=70) based on aspergillosis co-infection status. Clinical data from both groups were collected, and univariate analysis was performed to identify statistically significant factors.
    Results Independent risk factors for PTB-CPA included age ≥60 years (OR=4.056; 95%CI, 1.062 to 17.037), male sex (OR=0.121; 95%CI, 0.022 to 0.514), prolonged dust exposure (OR=22.476; 95%CI, 3.966 to 192.02), recurrent broad-spectrum antibiotic use (OR=5.372; 95%CI, 1.364 to 25.957), concurrent bronchiectasis (OR=6.889; 95%CI, 1.605 to 34.065), and body mass index (BMI) ≤22 kg/m2 (OR=7.813; 95%CI, 1.735 to 44.447).
    Conclusion Pulmonary tuberculosis patients with age ≥60 years, gender of male, prolonged dust exposure, recurrent broad-spectrum antibiotic use, concurrent bronchiectasis, and BMI ≤22 kg/m2 exhibit increased susceptibility to aspergillosis co-infection. A nomogram model effectively predicts PTB-CPA risk, and early identification of these factors may enhance diagnostic accuracy.

     

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