新生儿呼吸机相关性肺炎的病原分析及其炎性介质水平变化  

Etiology and the Level of Inflammatory Mediators into Plasma in Ventilator Associated Pneumonia of Neonte

作　　者：杨秀芳[1] 郑铠军[1] 陈简[1] 黄惠娟[1] 陈敬国[1] 

机构地区：[1]中山大学附属中山医院新生儿科,广东中山528403

出　　处：《中国临床医学》2010年第6期865-867,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:分析新生儿呼吸机相关性肺炎(VAP)的病原及患者外周血中炎性介质水平。方法:将需呼吸机治疗的252例患儿分为2组,研究组为90例呼吸机相关性肺炎的患儿;对照组为162例未合并呼吸机相关性肺炎的患儿,动态观察外周血中炎症介质在呼吸机治疗前后的变化。结果:病原菌主要是耐药性条件致病菌,以革兰阴性杆菌为主(76.7%)。对照组随着病情的好转,血浆炎症介质水平逐渐降低;而研究组随着VAP的发生炎症介质水平有不同程度的升高,随着感染的控制,水平逐渐下降。结论:致病菌主要是耐药性条件致病菌,外周血炎症介质水平与VAP的发生及病情的进展密切相关,可成为VAP发生及病情进展的参考指标。Objective：Ventilator associated pneumonia（VAP） is a common nosocomial infection and is responsible for a very high mortality in neonatal intensive care unit（NICU） patients.This study was designed to investigate the changes in inflammatory mediators in plasma in ventilator associated pneumonia.Methods： A total of 252 children treated with ventilator support in our neonatal intensive care unit from 2003 to 2009.They were assigned and divided into two groups.The experimental group（162 children of them were without ventilator associated pneumonia） was the patients with VAP and the control group（90 children of them were diagnosed as ventilator associated pneumonia） was the patients without VAP.The contents of tumor necrosis factor-α（TNF-α）,interleukin-6 in plasma were measured.Results： The detection rate of gram negative bacilli（76.7%） was the highest in VAP patients.There were statistical differences in the amount of inflammatory mediators released between the experimental group and the control group.In the experimental group,the contents of tumor necrosis factor-α（TNF-α）,interleukin-6 in plasma increased obviously,but decreased after receiving effective treatment.Conclusions： Opportunistic drug resistant bacteria are common pathogens for VAP.Inflammatory mediators into plasma can be a indification for the occurrence and development of VAP.

关 键 词：呼吸机相关性肺炎 病原学 炎症介质 

分 类 号：R563.1[医药卫生—呼吸系统]