AECOPD患者铜绿假单胞菌和肺炎克雷伯菌感染因素分析  

Analysis of factors of Pseudomonas aeruginosa and Klebsiella pneumoniae infection in patients with AECOPD

作　　者：段友红 郭普[2] 梁友宝[1] 陈尧[1] 赵德根 常滋毓[1] DUAN Youhong;GUO Pu;LIANG Youbao;CHEN Yao;ZHAO Degen;CHANG Ziyu(Department of Laboratory,Bengbu First People's Hospital,Anhui 233000,China;不详)

机构地区：[1]蚌埠市第一人民医院检验科,安徽233000 [2]蚌埠医学院第一附属医院检验科

出　　处：《医学动物防制》2023年第5期456-460,464,共6页Journal of Medical Pest Control

基　　金：安徽高校自然科学研究项目(KJ20210761);蚌埠市科技创新指导类项目(20200301)。

摘　　要：目的探讨慢性阻塞性肺部疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD),铜绿假单胞菌(Pseudomonas aeruginosa,PAE)感染患者和肺炎克雷伯菌(Klebsiella pneumoniae,KPN)感染患者感染的风险因素和疾病转归。方法以2018年1月至2020年12月蚌埠市某医院114例AECOPD病例为研究对象,根据是否发生肺部感染分为KPN感染组25例,PAE感染组39例,无感染对照组50例。收集所有病例临床资料,单因素和多因素回归分析AECOPD患者PAE和KPN感染的危险因素,比较3组患者再入院和死亡率的结果探讨疾病转归的差异。结果单因素和多因素回归分析结果显示,住院时间[OR=1.304(95%CI:1.014~1.677)]、合并肺源性心脏病[OR=7.884(95%CI:1.081~57.508)]、抗生素使用天数[OR=1.440(95%CI:1.079~1.922)]、机械通气[OR=26.976(95%CI:1.239~587.162)]是AECOPD患者发生PAE感染的独立危险因素(P<0.05);住院时间[OR=1.431(95%CI:1.028~1.993)]和合并肺源性心脏病[OR=23.235(95%CI:2.900~186.154)]是KPN感染的独立危险因素(P<0.05);PAE组死亡率高于对照组和KPN组(P<0.05),3组在再入院次数(1次、2次、≥3次分别为(χ^(2)=0.715、0.166、1.404,P>0.05)及最快再入院间隔时间(χ^(2)=0.529,P>0.05)差异无统计学意义。结论住院时间、合并肺源性心脏病、抗生素使用天数和机械通气与AECOPD患者PAE感染有关,住院时间和合并肺源性心脏病与KPN感染有关,临床医生要针对风险因素早期采取预防治疗措施,降低病死率,保障患者生命健康。Objective To investigate the risk factors and disease outcome of Pseudomonas aeruginosa(PAE)infection and Klebsiella pneumoniae(KPN)infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 114 cases of AECOPD in a hospital in Bengbu from January 2018 to December 2020 as the research subjects were divided into 25 cases in KPN group,39 cases in PAE group and 50 cases in control group.The clinical data of all cases were collected,and the risk factors of PAE and KPN infection in AECOPD patients were analyzed by univariate and multivariate regression.The results of readmission and mortality of the three groups were compared to explore the difference of disease outcome.Results Univariate and multivariate regression analysis showed that hospital stay[OR=1.304(95%CI:1.014-1.677)],pulmonary heart disease[OR=7.884(95%CI:1.081-57.508)],antibiotic use days[OR=1.440(95%CI:1.079-1.922)],mechanical ventilation[OR=26.976(95%CI:1.239-587.162)]were independent risk factors for PAE infection in patients with AECOPD(P<0.05).Hospital stay[OR=1.431(95%CI:1.028-1.993)]and pulmonary heart disease[OR=23.235(95%CI:2.900-186.154)]were independent risk factors for KPN infection(P<0.05).The mortality of PAE group was higher than that of control group and KPN group(P<0.05).There was no significant difference in the number of readmissions(χ^(2)=0.715,0.166 and 1.4041 time,2 times and≥3 times respectively,P>0.05)and the fastest interval between readmissions(χ^(2)=0.529,P>0.05).Conclusion Hospital stay,pulmonary heart disease,antibiotic use days and mechanical ventilation are related to PAE infection in AECOPD patients.Hospital stay and pulmonary heart disease are related to KPN infection.Clinicians should take early preventive and therapeutic measures according to risk factors to reduce mortality and ensure patients'life and health.

关 键 词：AECOPD 铜绿假单伯菌 肺炎克雷伯菌 危险因素 转归 分析 

分 类 号：R563[医药卫生—呼吸系统]