支气管扩张合并支气管哮喘患者的病原菌检测及危险因素分析  

Etiological detection and risk factors analysis in bronchiectasis patients with bronchial asthma

作　　者：张丽娟[1] 

机构地区：[1]湖州市中心医院呼吸内科,浙江湖州313000

出　　处：《中国微生态学杂志》2017年第11期1305-1308,共4页Chinese Journal of Microecology

摘　　要：目的分析支气管扩张合并支气管哮喘患者的病原菌及危险因素。方法选取湖州市中心医院115例支气管扩张合并支气管哮喘患者作为观察组,另选取同期110例健康体检者作为对照组。分析患者病原菌的组成、耐药性及发病危险因素。结果观察组患者送检痰样本经痰培养,阳性检出者68例,阳性率为59.13%(68/115)。全部样本共分离出104株病原菌,其中革兰阴性菌92株(以铜绿假单胞菌最多,占54.81%),革兰阳性菌8株,真菌4株。药敏试验结果表明革兰阴性菌对复方新诺明、头孢曲松、左旋左氧氟沙星和阿莫西林/克拉维酸等药物的耐药性均较高,对妥布霉素、亚胺培南、头孢哌酮/舒巴坦和哌拉西林的耐药性较低。Logistic回归分析显示,吸烟史、药物过敏史、食物过敏史、过敏性鼻炎、哮喘、过敏性肺炎、慢性支气管炎及慢性阻塞性肺疾病均是支气管扩张伴支气管哮喘发生的危险因素。结论支气管扩张合并支气管哮喘患者其病原菌以革兰阴性菌为主,吸烟史、药物过敏史、食物过敏史、过敏性鼻炎等是支气管扩张伴支气管哮喘发生的危险因素。Objective To analyze the pathogens and risk factors of bronchiectasis in conjunction with bronchial asthma.Methods 115 bronchiectasis patients with bronchial asthma in our hospital were enrolled as the observation group,with 110 healthy individuals as the control group.The composition of pathogenic bacteria,drug resistance and risk factors were analyzed.Results 68 of the 115 patients（59.13%）had positive result by sputum culturing.A total of 104 strains of pathogenic bacteria were isolated,including 92 gram negative bacteria（Pseudomonas aeruginosa accounting for 54.81%）,8 strains of gram positive bacteria,and 4 strains of fungi.The resistance of gram negative bacteria to Cotrimoxazole,Ceftriaxone,Levofloxacin and Amoxicillin/clavulanic acid were high,while the resistance to Imipenem,Tobramycin,Cefoperazone/sulbactam and Piperacillin were low.Logistic regression analysis showed that smoking history,drug allergy,food allergy,allergic rhinitis,allergic asthma,pneumonia,chronic bronchitis and chronic obstructive pulmonary disease were the risk factors of bronchiectasis in conjunction with bronchial asthma.Conclusion The main pathogen of bronchiectasis in conjunction with bronchial asthma was gram negative bacteria,and the risk factors were smoking history,drug allergy,food allergy,allergic rhinitis and so on.

关 键 词：支气管扩张合并支气管哮喘 病原菌 耐药性 危险因素 

分 类 号：R562.2[医药卫生—呼吸系统]