老年患者肺部感染诱发心力衰竭的X线表现及临床特征研究  

X-ray findings and clinical characteristics of elderly patients with heart failure induced by pulmonary infections

作　　者：郑劼[1] 陈波[1] 狄幸波[1] 岑雪降[1] 徐建国[1] 王志平[1] 

机构地区：[1]浙江省人民医院放射科,浙江杭州310014

出　　处：《中华医院感染学杂志》2014年第14期3490-3491,3494,共3页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科学研究基金资助项目(2013ZB019)

摘　　要：目的研究因肺部感染诱发心力衰竭患者的X线表现及其临床特征,为临床对肺部感染诱发心力衰竭的诊断和治疗提供依据。方法收集2011年12月-2012年12月医院收治的心力衰竭老年患者,分析患者发生心力衰竭诱因、临床特征、X线表现及感染菌型,采用SPSS20.0统计软件进行分析。结果心力衰竭老年患者152例,其中83例肺部感染,占54.61%;肺部感染诱发心力衰竭以左心力衰竭为主,临床表现肺部啰音为100.00%、浮肿为90.36%、肝肿大为90.36%、慢性咳嗽为87.95%;X线表现为心脏增大,斑片状阴影和(或)蝴蝶状阴影,肺透亮度降低等;痰培养结果感染病原菌依次为真菌38株占45.78%、革兰阳性菌31株占37.35%、革兰阴性菌14株占16.87%。结论老年患者心力衰竭的主要诱因为肺部感染,临床上可结合患者X线表现和其临床特征对老年人肺部感染诱发心力衰竭进行判断,并针对感染病原菌进行治疗。OBJECTIVE To investigate the X-ray findings and clinical characteristics of the patients with heart failure induced by pulmonary infections so as to provide guidance for the diagnosis and treatment of the pulmonary infections-induced heart failure.METHODS The elderly patients with heart failure who were treated in the hospital from Dec 2011to Dec 2012were enrolled in the study,then the causes of heart failure,clinical characteristics,Xray findings,and species of pathogenic bacteria were analyzed,and the statistical analysis was performed with the use of SPSS20.0software.RESULTS Of the 152elderly patients with heart failure,the pulmonary infections occurred in 83（54.61%）cases.Among the patients with heart failure induced by pulmonary infections,the patients with left heart failure were dominant.Of all the clinical manifestations,the pulmonary rales accounted for100.00%,the edema 90.36%,the hepatomegaly 90.36%,the chronic cough 87.95%;the X-ray findings showed the cardiac enlargement,patchy shadows and/or butterfly-shaped shadow,and decreased lung permeability brightness.According to the results of sputum culture,the isolated pathogens included 38（45.78%）strains of fungi,31（37.35%）strains of gram-positive bacteria,and 14（16.87%）strains of gram-negative bacteria.CONCLUSIONThe pulmonary infection is the leading cause of heart failure in the elderly patients.The clinicians should diagnose the pulmonary infection-induced heart failure based on the X-ray findings and clinical characteristics of the elderly patients and focus on treatment of the infections caused by the pathogens.

关 键 词：老年患者 肺部感染 心力衰竭 X线 病原菌 

分 类 号：R563[医药卫生—呼吸系统]