慢性阻塞性肺疾病患者肺部感染的临床特征及病原菌分布  

Clinical characteristics and distribution of pathogenic bacteria in chronic obstructive pulmonary disease patients with pulmonary infections

作　　者：周敏[1] 余祖琳[1] 王美芳[1] 朱立颖[1] 罗金剑 

机构地区：[1]浙江省安吉县人民医院呼吸内科,浙江安吉县313300

出　　处：《中华医院感染学杂志》2017年第14期3158-3160,3175,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)伴肺部感染患者的临床特征及病原菌分布,为临床预防及治疗提供参考依据。方法选取2012年1月-2016年6月于医院呼吸内科收治的COPD患者642例,按是否感染分为肺部感染组310例和非肺部感染组332例;全面评估患者肺部感染情况,对患者进行相关病原学检查,对结果进行相关分析。结果肺部感染组患者在使用呼吸机、合并糖尿病、卧床方面分布率均高于非肺部感染组;肺部感染组患者在血红蛋白、血清白蛋白、用力肺活量(FVC1)、第1秒用力呼气容量(FEV_1)、FEV_1/FVC、动脉氧分压方面与非肺部感染组比较,差异均有统计学意义(P<0.05);共送检肺部感染患者痰液标本310份,共检出251株病原菌,以革兰阴性菌为主,共158株占62.95%。结论 COPD患者肺部感染率较高,肺部感染病原菌以革兰阴性菌所占比重更大。OBJECTIVE To investigate the clinical characteristics and distribution of pathogens in patients with chronic obstructive pulmonary disease（COPD）and pulmonary infections,so as to provide references for clinical prevention and treatment.METHODS A total of 642 cases of COPD patients were enrolled in the department of respiratory medicine from Jan.2012 to Jun.2016.According to whether the patients were infected or not,they were divided into pulmonary infection group（n=310）and non pulmonary infection group（n=332）.The pulmonary infection situations of patients were comprehensively evaluated,the relative pathogenic examinations were carried out,and the results were correlatively analyzed.RESULTS The distribution rates of the use of ventilator,diabetes mellitus and bed rest of patients in pulmonary infection group were higher than those in non pulmonary infection group.The levels of hemoglobin,serum albumin,forced vital capacity（FVC）,forced expired volume in one secind（FEV1）,FEV1/FVC,and arterial oxygen had significant differences between the two groups of patients（P〈0.05）.A total of 251 strains of pathogens were detected from 310 sputum specimens in patients with pulmonary infections,which were mainly 158 strains of gram-negative bacteria,accounting for 62.95%.CONCLUSIONPulmonary infection rate in patients with COPD is high,and the main pathogens are gram-negative bacteria.

关 键 词：慢性阻塞性肺疾病 肺部感染 危险因素 病原学检测 

分 类 号：R563[医药卫生—呼吸系统]