老年心力衰竭合并肺部感染患者的病原学特征及危险因素分析  

Pathogenic characteristics and risk factors in elderly patients with heart failure complicated by pulmonary infection

作　　者：王明娇 陈娟[1] 刘波 曾素根[1] WANG Mingjiao;CHEN Juan;LIU Bo;ZENG Sugen(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 611135,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都611135

出　　处：《国际检验医学杂志》2022年第9期1075-1078,1084,共5页International Journal of Laboratory Medicine

基　　金：四川省科技计划项目(2021YFS0331)。

摘　　要：目的分析老年心力衰竭(简称心衰)合并肺部感染患者的危险因素及病原学特征。方法回顾性分析2017年1月至2019年1月该院收治的387例老年心衰患者的临床资料,并按照是否发生医院内肺部感染分为感染组(175例)与非感染组(212例),所有感染组患者进行细菌培养鉴定和药敏试验。采用单因素及二元Logistic回归分析老年心衰患者合并肺部感染的相关危险因素。结果387例老年心衰患者中,合并肺部感染175例,感染率为45.2%。感染组患者共培养出病原菌173株,其中革兰阳性菌15株,占8.67%,以金黄色葡萄球菌为主,其次为纹状棒状杆菌;革兰阴性菌158株,占91.33%,以鲍曼不动杆菌为主,其次为肺炎克雷伯菌。不同年龄、性别、高血压状态、糖尿病状态、心功能分级老年心衰患者肺部感染率比较,差异均有统计学意义(P<0.05),且年龄≥70岁、糖尿病是老年心衰患者合并肺部感染的独立危险因素(P<0.05)。结论老年心衰患者合并肺部感染与多种危险因素有关,主要病原菌以革兰阴性菌为主,临床早期应采取措施做好积极预防,并根据病原菌检测结果合理使用抗菌药物。Objective To analyze the risk factors and pathogenic characteristics of elderly patients with heart failure complicated by pulmonary infection.Methods The clinical data of totally 387 elderly patients with heart failure admitted to the hospital from January 2017 to January 2019 were retrospectively analyzed,and the patients were divided into infection group(175 cases)and non-infection group(212 cases)according to whether nosocomial pulmonary infection occurred.All patients in the infection group underwent bacterial culture identification and drug sensitivity test.Single factor and binary Logistic regression were used to analyze the related risk factors of elderly patients with heart failure complicated by pulmonary infection.Results Among the 387 elderly patients with heart failure,175 cases were complicated with pulmonary infection,and the infection rate was 45.2%.A total of 173 pathogenic bacteria were cultured in the infection group,of which 15 gram-positive bacteria accounted for 8.67%,mainly Staphylococcus aureus,followed by Corynebacterium striatum.A total of 158 strains of gram-negative bacteria accounted for 91.33%,mainly Acinetobacter baumannii,followed by Klebsiella pneumoniae.The infection rates in elderly patients with heart failure with different age,gender,hypertension status,diabetes status,and cardiac function classification were statistically significant(P<0.05),and age above or equal to 70 years old and diabetes were independent risk factors for elderly patients with heart failure complicated by pulmonary infection(P<0.05).Conclusion Pulmonary infection in elderly patients with heart failure relates to a variety of risk factors.The main pathogens are gram-negative bacteria.Measures should be taken to prevent them in the early clinical stage,and antibiotics should be used rationally based on the results of pathogen detection.

关 键 词：心力衰竭 肺部感染 病原菌 危险因素 

分 类 号：R446.5[医药卫生—诊断学]