慢性阻塞性肺部疾病患者肺部感染危险因素分析及炎症因子水平变化  

Analysis of risk factors of pulmonary infection and changes of inflammatory factors in patients with chronic obstructive pulmonary disease

作　　者：陶赟臻 赵晓秋 刘晓倩 李建英 TAO Yun-zhen;ZHAO Xiao-qiu;LIU Xiao-qian;LI Jian-ying(Zhangjiakou First Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市第一医院,河北张家口075000

出　　处：《中国消毒学杂志》2023年第6期448-452,共5页Chinese Journal of Disinfection

基　　金：河北省张家口市2019年市级科技计划自筹经费项目(1921088D)。

摘　　要：目的 分析慢性阻塞性肺部疾病(COPD)患者炎症因子水平变化,并探讨其肺部感染的危险因素。方法选取150例COPD患者为研究对象,根据肺部感染情况将其分为感染组和未感染组,对比两组患者临床资料,采用多因素logistic回归分析COPD患者肺部感染的独立危险因素。结果 42.00%的患者发生肺部感染,共培养出52株病原菌,以革兰阴性菌为主,构成比为67.31%。年龄、合并症、住院时间、呼吸情况、抗菌药物使用时间、IL-1β、IL-2、IL-4、IL-6、IL-8、TNF-α、TNF-β、IFN-α、IL-10和IFN-γ均为COPD患者肺部感染的影响因素(P <0.05)。年龄≥60周岁、合并症种类≥2种、住院时间≥30 d、机械性通气和抗菌药物使用时间≥15 d均为COPD患者肺部感染的独立危险因素(P <0.05),构建的列线图预测模型具有良好的预测效能。结论 年龄≥60岁、合并症种类≥2种、住院时间≥30 d、机械性通气和抗菌药物使用时间≥15 d均为COPD患者肺部感染的独立危险因素,临床医师还应结合患者血清炎症因子水平对患者病情进行全面评估,并及时进行干预。Objective To analyze the changes of inflammatory factors in patients with chronic obstructive pulmonary disease(COPD),and to explore the risk factors of pulmonary infection.Methods 150 COPD patients were selected as the research objects,and they were divided into infection group and non-infection group according to the pulmonary infection status.The clinical data of the two groups were compared.The independent risk factors of pulmonary infection in COPD patients were analyzed using multivariate logistic regression analysis.Results 42.00%of the patients had pulmonary infection,and a total of 52 strains of pathogenic bacteria were cultured,mainly Gram-negative bacteria(67.31%).Age,comorbidities,length of stay,respiratory condition,duration of antibiotic use,IL-1β,IL-2,IL-4,IL-6,IL-8,TNF-α,TNF-β,IFN-α,IL-10 and IFN-γwere all the influencing factors of pulmonary infection in COPD patients(P<0.05).Age≥60 years,number of comorbidity type≥2,length of stay≥30 d,duration of mechanical ventilation and antibiotic use≥15 d were all independent risk factors for pulmonary infection in COPD patients(P<0.05),and the constructed nomogram prediction model had good prediction preformance.Conclusion Age≥60 years,number of comorbidity type≥2,length of stay≥30 d,duration of mechanical ventilation and antibiotic use≥15 d are all independent risk factors for pulmonary infection in COPD patients,and clinicians should also comprehensively assess patients'condition and timely intervene in combination with patients'serum inflammatory factor level.

关 键 词：慢性阻塞性肺部疾病 肺部感染 危险因素 炎症因子 

分 类 号：R181.32[医药卫生—流行病学] R378[医药卫生—公共卫生与预防医学]