老年感染性肺炎呼吸道菌群分布及临床特征观察  

Observation on the Distribution and Clinical Characteristics of Respiratory Tract Flora in Elderly Patients with Infectious Pneumonia

作　　者：汪玲玲[1] 申潇竹[1] 包勤文[1] WANG Lingling;SHEN Xiaozhu;BAO Qinwen(Lianyungang Second People's Hospital,Lianyungang 222000,China;不详)

机构地区：[1]连云港市第二人民医院,江苏连云港222000

出　　处：《中外医学研究》2023年第4期76-79,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析老年感染性肺炎呼吸道菌群分布及临床特征。方法:选择2020年5月—2022年5月连云港市第二人民医院收治的64例老年感染性肺炎患者为观察组,采用临床肺部感染评分(CPIS)评估观察组肺部感染程度,根据CPIS评分将观察组分为轻度组(CPIS评分<6分,36例)和重度组(CPIS评分≥6分,28例);另选取同期本院收治的56例老年肺气肿患者为对照组。观察老年感染性肺炎患者呼吸道菌群分布情况,比较各组香农-维纳多样性指数[Shannon-Wiener diversity index,SHDI]和辛普森多样性指数(Simpson多样性指数),并分析各组免疫功能情况及血清炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、免疫球蛋白G(IgG)水平及T淋巴细胞亚群CD3^(+)、CD4^(+)/CD8^(+)分布情况。结果:64例老年感染性肺炎患者中,细菌培养阳性率为65.63%(42/64),共检出细菌数85株,其中革兰阴性菌69株,占81.18%,以铜绿假单胞菌属所占比例最高,其次为肺炎克雷伯菌、大肠埃希菌;革兰阳性菌16株,占18.82%,以金黄色葡萄球菌为主。轻度组与重度组SHDI均显著低于对照组,Simpson多样性指数显著高于对照组,差异均有统计学意义(P<0.05);重度组SHDI显著低于轻度组,差异有统计学意义(P<0.05)。轻度组与重度组IgG、CD3^(+)、CD4^(+)/CD8^(+)水平均显著低于对照组,IL-6、TNF-α水平均显著高于对照组,差异均有统计学意义(P<0.05);重度组IgG、CD4^(+)/CD8^(+)水平均显著低于轻度组,IL-6、TNF-α水平均显著高于轻度组,差异均有统计学意义(P<0.05)。结论:老年感染性肺炎患者呼吸道菌群分布以铜绿假单胞菌、肺炎克雷伯菌为主,且患者SHDI降低、Simpson多样性指数升高,免疫功能下降。Objective:To analyze the distribution and clinical characteristics of respiratory flora in elderly patients with infectious pneumonia.Method:A total of 64 elderly patients with infectious pneumonia admitted to Lianyungang Second People’s Hospital from May 2020 to May 2022 were included as the observation group.The clinical pulmonary infection score (CPIS) was used to evaluate the degree of pulmonary infection in the observation group.According to the CPIS score,the observation group were divided into mild group(CPIS score<6 points,36 cases) and severe group (CPIS score≥6 points,28 cases).Other 56 elderly patients with emphysema admitted to our hospital during the same period were selected as the control group.Observed the distribution of respiratory tract flora in elderly patients with infectious pneumonia,compared the Shannon-Wiener diversity index (SHDI) and Simpson’s diversity index of each group,analyzed the immune function of each group,and observed the levels of serum inflammatory cytokines interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),immunoglobulin G (IgG),and the distribution of T lymphocyte subsets CD3^(+),CD4^(+)/CD8^(+).Result:Among the 64elderly patients with infectious pneumonia,the positive rate of bacterial culture was 65.63%(42/64),85 bacterial strains were detected,including 69 strains of Gram negative bacteria,accounting for 81.18%,the proportion of Pseudomonas aeruginosa was the highest,followed by Klebsiella pneumoniae and Escherichia coli.There were 16 strains of Gram positive bacteria,accounting for 18.82%,mainly Staphylococcus aureus.Both the SHDI in mild group and severe group were significantly lower than that in control group,Simpson’s diversity indexes were significantly higher than that in control group,the differences were statistically significant (P<0.05).The SHDI in severe group was significantly lower than that in mild group,the differences were statistically significant (P<0.05).The levels of IgG,CD3^(+),CD4^(+)/CD8^(+)in the mild group and severe group were sig

关 键 词：老年人 感染性肺炎 呼吸道 菌群 香农-维纳多样性指数 辛普森多样性指数 免疫功能 

分 类 号：R563.1[医药卫生—呼吸系统] R446.5[医药卫生—内科学]