老年高龄COPD患者急性发作期的细菌感染的特点  

The Clinical Feature and Bacterial Infection Character in Old Patients with Exacerbated Stage of COPD

作　　者：罗艳蓉[1] 韩志青[1] 陈旭波[1] 徐晓雯[1] 徐兆余[1] 

机构地区：[1]上海市杨浦区中心医院呼吸科,上海200090

出　　处：《中国临床医学》2002年第4期417-419,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :提高对老年高龄慢性阻塞性肺部疾病 (COPD)患者急性发作期细菌感染特点的认识。方法 :对我科近 4年的 14 2例 80岁以上急性发作期COPD住院患者的临床资料和呼吸道分泌物的细菌培养结果进行回顾性分析。结果 :14 2例患者中 ,检出细菌 15 9株 ,其中革兰阳性菌占 2 2 .0 % (金黄色葡萄球菌为主 ) ,敏感的药物主要是万古霉素、复方新诺明 ,利福平 ;革兰阴性菌占 6 5 .4 % (以肺炎杆菌、铜绿假单胞菌、硝酸盐阴性杆菌为主 ) ,敏感的药物主要是阿米卡星、头孢他啶、亚胺培南 ;抗酸杆菌占 12 .6 %。 14 2例患者中 ,单纯COPD占 36 .6 % ,同时有两种或两种以上并发症或合并症占 70 .4 % ,且后者更容易发生革兰阴性菌感染。结论 :80岁以上的COPD急性发作期患者 ,呼吸道感染以革兰阴性细菌为主 ,有合并症患者的比例更高。抗酸杆菌的发现率高达 12 .6 %。Objective: To recognize the clinical feature and bacterial infection character of old patients with exacerbated stage of chronic obstructive pulmonary disease (COPD). Methods: To collect data of 142 COPD patients over 80 years old with exacerbation. Retrospective analysis of clinical data and bacterium culture of respiratory tract secretion. Results: 159 bacterium cultures were checked out in 142 case, Gram positive organisms accounted for 22.0%(Mainly Staphylococcus aureus), the susceptible drug are vancomycin?co-trimoxazole, rifampin; Gram negative organisms accounted for 65.4% (Mainly Klebsiella pneumoniae, Pseudomonas aeruginosa, Cinetobacter antratus); amikacin?ceftazidime?imipenem; and acid- fast bacillus accounted for 12.6%. Purely chronic obstructive pulmonary disease accounted for 36.6%, complication with two diseases or two diseases accounted for 70.4%. Conclusion: Respiratory tract infection of old COPD patients with exacerbated stage is mainly by Gram-negative organisms; patients with complication of proportion were higher.

关 键 词：COPD 急性发作期 细菌感染 慢性阻塞性肺疾病 革兰阴性杆菌 革兰阳性球菌 老年人 

分 类 号：R563[医药卫生—呼吸系统]