非小细胞肺癌合并下呼吸道感染患者气道定植菌分布及危险因素分析  

Distribution and Risk Factors of Airway Colonization Bacteria in Patients with Non-small cell Lung Cancer Combined with Lower Respiratory Tract Infection

作　　者：尤雷[1] 翟俊伟[3] 刘艳虹 吴国峰 邸庆国[2] YOU Lei;ZHAI Jun-wei;LIU Yan-hong;WU Guo-feng;DI Qing-guo(Department of General Internal Medicine,the Central Hospital of Cangzhou,Cangzhou,Hebei 061000,China;Department of Respiratory and Critical Care,the Central Hospital of Cangzhou,Cangzhou,Hebei 061000,China;Department of Clinical Laboratory,the Fengnan District Hospital of Tangshan City,Tangshan,Hebei 063300,China)

机构地区：[1]沧州市中心医院综合内科,河北沧州061000 [2]沧州市中心医院呼吸与危重症科,河北沧州061000 [3]唐山市丰南区医院检验科,河北唐山063300

出　　处：《临床误诊误治》2022年第3期103-106,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究课题计划项目(20211288)。

摘　　要：目的研究非小细胞肺癌(NSCLC)合并下呼吸道感染患者气道定植菌分布情况,并分析其影响因素。方法选取2019年1月—2021年1月我院收治的118例NSCLC,根据是否合并下呼吸道感染分为感染组68例和非感染组50例。采集感染组痰液标本分析气道定植菌分布情况;收集所有患者临床资料,采用多因素Logistic回归分析探讨NSCLC合并下呼吸道感染的影响因素。结果感染组共检出细菌92株,其中革兰阴性菌67株(72.83%),以肺炎克雷伯菌占比最高,其次为铜绿假单胞菌、大肠埃希菌;革兰阳性菌25株(27.17%),以肺炎链球菌为主。多因素Logistic回归分析显示,年龄大、有糖尿病史、病程长、住院时间长、肿瘤分期高、中性粒细胞高、CD4+/CD8+降低是NSCLC合并下呼吸道感染的独立危险因素(P<0.05,P<0.01)。结论NSCLC合并下呼吸道感染患者气道定植菌以革兰阴性菌为主,肺炎克雷伯菌、肺炎链球菌、铜绿假单胞菌等占比较高。年龄大、有糖尿病史、病程长、住院时间长、肿瘤分期高、中性粒细胞高、CD4+/CD8+降低是NSCLC合并下呼吸道感染的独立危险因素。Objective To study the distribution of airway colonization bacteria in patients with non-small cell lung cancer(NSCLC)combined with lower respiratory tract infection and to analyze influencing factors.Methods A total of 118 patients with NSCLC admitted between January 2019 and January 2021 were selected as the research subjects,and the patients were divided into infection group(n=68)and non-infection group(n=50)according to whether or not having lower respiratory tract infection.Sputum samples in infection group were collected to analyze distribution of bacteria colonizing the airway.Clinical data of all patients was collected,and multivariate Logistic regression analysis was used to explore influencing factors of patients with NSCLC combined with lower respiratory tract infection.Results A total of 92 strains of bacteria were detected in infection group,in which there was 67 strains of gram-negative bacteria(72.83%)with Klebsiella pneumoniae accounting for the highest proportion,followed by pseudomonas aeruginosa and escherichia coli;there was 25 strains of gram-positive bacteria(27.17%),mainly streptococcus pneumoniae.Multivariate Logistic regression analysis showed that elderly,history of diabetes,longer course of disease,longer hospitalization,higher tumor staging,increased neutrophils and decreased CD4+/CD8+ were independent risk factors for patients with NSCLC combined with lower respiratory tract infection(P<0.05,P<0.01).Conclusion Gram negative bacteria are the main colonization bacteria in airway of patients with NSCLC combined with lower respiratory tract infection,and Klebsiella pneumoniae,streptococcus pneumoniae and pseudomonas aeruginosa have high proportions.Elderly,history of diabetes,longer course of disease,longer hospitalization,higher tumor staging,increased neutrophils and decreased CD4+/CD8+ are independent risk factors for patients with NSCLC combined with lower respiratory tract infection.

关 键 词：癌 非小细胞肺 呼吸道感染 气道定植菌 革兰阴性菌 影响因素分析 

分 类 号：R734.2[医药卫生—肿瘤] R56[医药卫生—临床医学]