老年冠心病合并肺部感染患者病原学特点及危险因素分析  

Pathogenic Characteristics and Risk Factors of Elderly Patients with Coronary Heart Disease Complicated by Pulmonary Infection

作　　者：郑运周[1] 侯天文 张会峰[1] 高鹏[1] 米明强 李亚娟[1] 宋静静 ZHENG Yun-zhou;HOU Tian-wen;ZHANG Hui-feng;GAO Peng;MI Ming-qiang;LI Ya-juan;SONG Jing-jing(Department of Clinical Laboratory,the 980th Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Clinical Laboratory,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]解放军联勤保障部队第九八〇(白求恩国际和平)医院检验实验科,石家庄050082 [2]河北省中医院检验科,石家庄050011

出　　处：《解放军医药杂志》2021年第8期70-73,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省2017年重点科技研究计划(20170965)。

摘　　要：目的探讨老年冠心病合并肺部感染患者病原学特点及危险因素,为其临床诊疗提供参考依据。方法回顾性分析2018年1月—2020年1月本院收治的451例老年冠心病患者的临床资料,分析合并肺部感染患者病原学特点及危险因素。结果451例老年冠心病中合并肺部感染55例,感染率12.20%,检出病原菌62株,其中革兰阴性菌45株(72.58%)、革兰阳性菌12株(19.35%)、真菌5株(8.06%)。年龄≥80岁、有吸烟史、住院时间≥30 d、合并慢性阻塞性肺疾病、血红蛋白<90 g/L、降钙素原≥0.50 ng/ml是影响老年冠心病患者并发肺部感染的独立危险因素(P<0.05,P<0.01)。结论老年冠心病合并肺部感染患者病原菌以革兰阴性菌为主,其肺部感染发生受多种因素影响,应重点关注导致其发生的独立危险因素,早期预防。Objective To investigate pathogenic characteristics and risk factors of elderly patients with coronary heart disease(CHD)complicated by pulmonary infection so as to provide reference for clinical diagnosis and treatment.Methods Clinical data of 451 elderly patients with CHD admitted between January 2018 and January 2020 was retrospectively analyzed.Pathogenic characteristics and risk factors of CHD complicated by pulmonary infection in elderly patients were analyzed.Results Among 451 elderly patients with CHD,55 patients were complicated by pulmonary infection,and the infection rate was 12.20%.A total of 62 strains of pathogenic bacteria were detected,which included 45 strains of gram-negative bacteria(72.58%),12 strains of gram-positive bacteria(19.35%)and 5 strains of fungi(8.06%).Age equal or more than 80 years old,smoking history,length of hospitalization equal or more than 30 d,combination of chronic obstructive pulmonary disease,hemoglobin less than 90 g/L,procalcitonin equal or more than 0.50 ng/ml were independent risk factors of pulmonary infection in elderly patients with CHD(P<0.05,P<0.01).Conclusion Gram negative bacteria are the main pathogens in elderly patients with CHD complicated by pulmonary infection.The occurrence of pulmonary infection is affected by various factors.Independent risk factors should be paid more attention so as to early prevention to avoid the occurrence of hospital infection.

关 键 词：冠心病 老年人 肺部感染 革兰阴性菌 革兰阳性菌 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]