社区获得性肺炎患者初始治疗反应影响因素分析  

An analysis of factors influencing initial therapeutic response of patients with community-acquired pneumonia

作　　者：周晗慧 倪海滨[1] 赵慧[1] 胡星星[1] ZHOU Hanhui;NI Haibin;ZHAO Hui(Emergency Department, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, CHINA)

机构地区：[1]南京中医药大学附属中西医结合医院急诊科,江苏210028

出　　处：《江苏医药》2019年第3期229-232,共4页Jiangsu Medical Journal

基　　金：国家自然科学基金(81673932)

摘　　要：目的分析社区获得性肺炎(CAP)患者初始治疗反应的影响因素。方法依据肺部感染控制窗评估将CAP患者605例分为初始治疗有反应组和无反应组。比较两组临床资料,分析CAP患者初始治疗反应性的影响因素。结果 605例患者中,506例对初始治疗有反应,99例对初始治疗无反应。两组年龄、临床肺部感染评分、气管插管比例、住院时间及ICU住院时间比较均有统计学差异(P<0.01);两组既往史中,糖尿病、心功能不全、脑卒中和长期卧床比例比较有统计学差异(P<0.05);两组初始治疗地点构成比、继发感染及免疫抑制比例比较也有统计学差异(P<0.05)。Logistic回归分析显示,年龄、基础疾病数量、降钙素原、有无免疫抑制及临床肺部感染评分是影响CAP患者初始治疗反应性的独立因素(P<0.01)。结论应结合年龄、基础疾病数量、降钙素原、有无免疫抑制状态和临床肺部感染评分等影响因素,综合判断疾病严重程度,指导CAP的诊治。Objective To investigate the factors influencing the initial therapeutic response in the patients with community-acquired pneumonia(CAP).Methods On the basis of the evaluation of pulmonary infection control window,605 patients with CAP were divided into two groups of A(with therapeutic response to initial treatment) and B(without therapeutic response to initial treatment).Clinical data were compared between two groups.The factors influencing the response to initial therapy were analyzed.Results Of the 605 patients,506 cases had therapeutic response to the initial treatment and 99 cases had no therapeutic response. There were significant differences in age,clinical pulmonary infection score(CPIS),tracheal intubation,hospital stay and ICU stay between two groups(P<0.01).The history of past illness such as diabetes mellitus,cardiac insufficiency,stroke and long-term bed were significantly different between two groups(P<0.05).So did the hospital conducted initial treatment,with secondary infection and immunosuppression(P<0.05).Logistic regression analysis showed that age,the number of underlying diseases,procalcitonin,immunosuppression status and CPIS were the independent factors influencing the initial therapeutic response in the patients with CAP(P<0.01).Conclusion To guide the diagnosis and treatment of CAP,the illness severity of CAP should be evaluated comprehensively including age,underlying diseases,procalcitonin,immunosuppression status and CPIS.

关 键 词：社区获得性肺炎 

分 类 号：R563[医药卫生—呼吸系统]