肺结核合并细菌性肺炎的影响因素及脂代谢变化  

Influencing factors for pulmonary tuberculosis complicated with bacterial pneumonia and change of lipid metabolism

作　　者：陈瑞华 谢婷 黄燕花 赵春娥 吕敬龙 CHEN Rui-hua;XIE Ting;HUANG Yan-hua;ZHAO Chun-e;LYU Jing-long(Graduate Training Base of Jinzhou Medical University(Three Gorges Hospital Affiliated to Chongqing University),Chongqing 404000,China)

机构地区：[1]锦州医科大学研究生培养基地(重庆大学附属三峡医院)感染科,重庆404000

出　　处：《中华医院感染学杂志》2022年第23期3572-3575,共4页Chinese Journal of Nosocomiology

基　　金：重庆市自然科学基金资助项目(20204698)。

摘　　要：目的分析肺结核(PTB)合并细菌性肺炎的影响因素,为临床工作提供依据。方法选取2019年12月-2020年12月医院感染科收治的195例PTB患者作为研究对象,根据是否合并细菌性肺炎将患者分为研究组(PTB合并细菌性肺炎患者,85例)和对照组(单纯PTB患者,110例),对两组患者的临床特征及入院时的血清脂代谢指标进行比较。结果研究组患者的合并糖尿病比例、具有吸烟史比例、PTB病程、空洞型结核比例、累及肺野数≥3个比例、长期应用糖皮质激素比例、长期应用抗菌药物比例均高于对照组(P<0.05)。研究组患者的血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)水平分别为(3.54±0.86)mmol/L、(0.80±0.15)mmol/L、(1.89±0.22)mmol/L、(0.77±0.23)g/L,均低于对照组(P<0.05)。Logistic多元回归模型分析结果显示,空洞型结核及血清TC、ApoA1水平为PTB合并细菌性肺炎发生的影响因素(P<0.05)。结论PTB合并细菌性肺炎的发生与多种因素相关,与单纯PTB患者相比较,此类患者的血清脂代谢指标水平更低,临床医生应根据这一特征开展针对PTB患者继发性感染的预防和诊断工作。OBJECTIVE To analyze the related factors for pulmonary tuberculosis(PTB)complicated with bacterial pneumonia,so as to provide basis for clinical work.METHODS Total of 195 patients with PTB treated in the department of infection of our hospital from Dec 2019 to Dec 2020 were recruited.According to whether they were complicated with bacterial pneumonia,the patients were divided into the study group(the patients with PTB complicated with bacterial pneumonia,85 cases)and the control group(the patients with simple PTB,110 cases).The clinical characteristics and the serum lipid metabolism indexes between the two groups were compared.RESULTS The proportion of patients with diabetes and smoking history,PTB duration,the proportion of cavitary tuberculosis.the number of involved lung fields≥3,long-term use of corticosteroids,and long-term use of antibiotics in the study group were higher than those in the control group(P<0.05).The serum levels of total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1)in the patients of the study group were(3.54±0.86)mmol/L,(0.80±0.15)mmol/L(1.89±0.22)mmol/L and(0.77±0.23)g/L,respectively,which were lower than those of the control group(P<0.05).Logistic multivariate regression model analysis showed that cavitary tuberculosis and serum TC and ApoA1 levels were the influencing factors for PTB complicated with bacterial pneumonia.CONCLUSION The incidence of PTB complicated with bacterial pneumonia were related to various factors.The levels of serum lipid metabolism indexes in these patients are lower than those in the patients with simple PTB.Clinicians should carry out the prevention and diagnosis of secondary infection in PTB patients according to this characteristic.

关 键 词：脂代谢 肺结核 细菌性肺炎 影响因素 

分 类 号：R521[医药卫生—内科学]