To study the etiology and risk factors of pulmonary fungal infection in patients with heart failure
Objective To investigate the pathogenic fungi distribution and risk factors of pulmonary fungal infection in pa-tients with heart failure (HF),so as to reduce the occurrence of pulmonary fungal infection and improve the prognosis of HF patients.Methods A total of 156 HF patients in the Emergency Department of the First Affiliated Hospital of Air Force Medical University from March 2020 to March 2024 were retrospectively included.According to whether pulmonary fungal infection was complicated,they were divided into infected group (n=78) and uninfected group (n=78).Fungal species were identified in the infected group,clinical data of the two groups were collected and analyzed.Logistic regression was used to analyze the risk factors of pulmonary fungal infection in HF patients,and receiver operating characteristics (ROC) curve was used to evaluate the accuracy of independent variables.Results A total of 93 fungal strains were detected in the infection group,including 36 strains (38.71％) detected in sputum culture and 57 strains (61.29％) detected in BALF cul-ture,with Candida albicans (50.54％) as the dominant strain,followed by Candida tropicalis (27.96％).Logistic multi-variate analysis showed that disease duration (OR=1.763),N-terminal B-type natriuretic peptide (NT-proBNP)(OR=1.421),cardiac troponin Ⅰ(cTnⅠ) (OR=42.407) and interleukin-6 (IL-6)(OR=2.209) were independent risk factors for pulmonary infection in HF patients (P<0.05).ROC curve analysis showed that the region under the curve (AUC) for combined prediction and evaluation of pulmonary infection was 0.995,95％ CI was 0.989～1.000,sensitivity was 0.962,and specificity was 0.936.Compared with AZ=0.5,the difference was statistically significant (P<0.05).Conclusion Candida albicans is the main pathogenic fungus in HF patients complicated with pulmonary fungal infection.Course of disease,NT-proBNP,cTnⅠ and IL-6 are independent risk factors for HF patients complicated with pulmonary fungal infection.
万方数据
维普
