Objective To investigate the influencing factors of death in patients with COPD and respiratory failure complicated with pulmonary fungal infection. Methods We selected 100 cases of deceased patients ( research group ) with COPD and respiratory failure complicated with pulmonary fungal infection who received treatment in the First People's Hospital of Yunnan Province from January,2008 to January,2013,and selected another 100 cases of cured patients( control group) of the same conditions. According to references and clinical observed results,we chose 14 factors that were more likely to influence death in patients with COPD and respiratory failure complicated with pulmonary fungal infection. The 14 factors were gender,age, duration of disease, occupation, body mass index, smoking, mechanical ventilation, two or more than two kinds of fungal infection,two or more than two kinds of organ failure,number of days using broad-spectrum antibiotics,two and more than two kinds of organ failure,combined use of antibiotics,proton pump inhibitor,bronchoscopy and hypoproteinemia. Univariate and multivariate logistic regression analyses were conducted. Results Univariate logistic regression analysis showed that the influences of age,duration of disease,smoking,mechanical ventilation,two or more than two kinds of fungal infection,two or more than two kinds of organ failure,combined use of antibiotics,and hypoproteinemia on death in patients with COPD and respiratory failure complicated with pulmonary infection were statistically significant(P﹤0. 05);the multivariate logistic regression analysis showed that the influences of duration of disease,two or more than two kinds of organ failure,combined use of antibiotics,and hypoproteinemia on death of patients with COPD and respiratory failure complicated with pulmonary infection were statistically significant(P﹤0. 05). Conclusion Long duration of disease,two or more than two kinds of organ failure,hypoproteinemia are the risk factors of death in patients with COPD and respiratory failure complicated with pulmonary infection,and combined use of antibiotics is the protective factor. Early prevention and control of these risk factors could improve the prognosis in patients and reduce case fatality rate.%目的：探讨慢性阻塞性肺疾病（ COPD）呼吸衰竭合并肺部真菌感染患者死亡的影响因素。方法选取云南省第一人民医院2008年6月—2013年1月收治的COPD呼吸衰竭合并肺部真菌感染死亡患者100例（研究组）与同期未死亡患者100例（对照组）作为研究对象。根据参考文献和临床上的观察结果，选择出COPD呼吸衰竭合并肺部真菌感染患者死亡的可能影响因素共14项，包括性别、年龄、病程、职业、体质指数、吸烟、机械通气、两种或两种以上真菌感染、两种或两种以上器官功能衰竭、广谱抗生素使用天数、抗生素的联合使用、质子泵抑制剂、支气管镜检查及低蛋白血症。采用单因素Logistic和多因素Logistic回归进行统计学分析。结果单因素Logistic回归分析结果显示，年龄、病程、吸烟、机械通气、两种或两种以上真菌感染、两种或两种以上器官功能衰竭、抗生素的联合使用、低蛋白血症对COPD呼吸衰竭合并肺部真菌感染患者死亡的影响有统计学意义（ P﹤0.05）。多因素Logistic回归分析结果显示，病程、两种或两种以上器官功能衰竭、抗生素的联合使用、低蛋白血症对COPD呼吸衰竭合并肺部真菌感染患者死亡的影响有统计学意义（ P ﹤0.05）。结论病程长、两种或两种以上器官功能衰竭、低蛋白血症是COPD呼吸衰竭合并肺部真菌感染患者死亡的危险因素，抗生素的联合使用是保护因素，提早对这些危险因素进行预防控制可以改善患者预后，降低病死率。
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