无反应性社区获得性肺炎的临床分析  

Clinical analysis of non-responding community-acquired pneumonia

作　　者：张淑立[1] 王毅[1] 刘学东[1] 葛云洁[1] 赵伟业[1] 

机构地区：[1]青岛市市立医院呼吸科,山东青岛266011

出　　处：《临床肺科杂志》2013年第7期1243-1244,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析无反应性社区获得性肺炎(CAP)的病原学及病因诊断。方法分析我院40例无反应性CAP,其中A组12例伴COPD等基础病,B组28例无基础病。按CAP指南治疗无效,后完善检查,明确诊断。结果 A组8例曲霉菌、3例结核;1例病原菌不详,在万古霉素联合头孢哌酮-舒巴坦治疗后好转。B组中,致病菌明确的耐药菌共10例,结核杆菌、曲霉菌各2例,非感染性疾病5例,肺炎链球菌合并结核菌1例;病原菌不详、在万古霉素联合头孢哌酮-舒巴坦治疗后好转8例。结论对伴基础病的无反应性CAP,以曲霉菌、结核菌感染常见,不伴基础病者,以耐药阳性球菌或阴性杆菌为主。Objective To analyze the etiology and other etiological diagnosis of patients with non-responding community-acquired pneumonia （CAP）. Methods The clinical data of 40 patients with non-responding CAP were retrospectively analyzed, which included 12 patients complicated with COPD, and other underlying diseases （the group A） and 28 patients without underlying diseases （the group B）. All patients were treated according to the CAP Manual and failed. Then the examination was completed and the final diagnosis was made. Results In the group A, there were 8 cases of aspergillus, 3 cases of mycobacterium tuberculosis, and 1 case of unknown patho- genic bacteria. In the group B, the pathogenic bacteria of 10 patients were confirmed, which included 2 cases of tuhercule bacillus and as- pergillus, 5 cases of non-infection diseases, and 1 case of streptococcus pneumoniae complicated with tubercule bacillus. There were 8 ea- ses of unknown pathogenic bacteria who turned better treated by vaneomycin combined with cefoperazone and sulbaetam. Conclusion In non-responding CAP patients with underlying diseases, aspergillus and tuberculosis are the common pathogenic bacteria. In those without underlying diseases, the resistant bacteria are the main pathogen.

关 键 词：无反应性社区获得性肺炎 病原学 病因分析 

分 类 号：R563.1[医药卫生—呼吸系统]