呼吸机相关性肺炎患者并发耐药菌感染的影响因素  

Influencing factors of drug-resistant bacteria infection in patients with ventilator-associated pneumonia

作　　者：胡新娥 方晓霞 程立 HU Xin’e;FANG Xiaoxia;CHENG Li(Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical College,Intensive Care Unit,,Xinxiang 453003 Henan,China;Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical College,Key Laboratory of Elderly Health Care and Promotion in Xinxiang City,Xinxiang 453003 Henan,China)

机构地区：[1]新乡市中心医院,新乡医学院第四临床学院重症监护室,河南新乡453003 [2]新乡市中心医院,新乡医学院第四临床学院,新乡市老年健康照护与促进重点实验室,河南新乡453003

出　　处：《中国民康医学》2025年第6期5-8,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析呼吸机相关性肺炎(VAP)患者并发耐药菌感染的影响因素。方法:回顾性分析2022年10月至2023年10月新乡市中心医院收治的206例VAP患者的临床资料,根据住院期间是否并发耐药菌感染将其分为感染组(n=124)和未感染组(n=82)。比较两组临床资料,采用Logistic回归分析VAP患者并发耐药菌感染的影响因素。结果:两组性别、住院时间、留置胃管、合并高血压、合并冠心病、应用糖皮质激素比较,差异均无统计学意义(P>0.05);两组年龄、体质量指数、抗菌药物使用时间、呼吸机使用时间、气管插管、合并慢性阻塞性肺疾病、合并糖尿病、抗菌药物联用、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、意识障碍、晚发型VAP、高迁移率族蛋白B1(HMGB1)比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,抗菌药物使用时间>8 d、呼吸机使用时间>10 d、多次气管插管、合并慢性阻塞性肺疾病、合并糖尿病、有抗菌药物联用、APACHEⅡ评分>15分、有意识障碍、晚发型VAP、HMGB1>45μg/L均为VAP患者并发耐药菌感染的危险因素(OR>1,P<0.05)。结论:抗菌药物使用时间>8 d、呼吸机使用时间>10 d、多次气管插管、合并慢性阻塞性肺疾病、合并糖尿病、有抗菌药物联用、APACHEⅡ评分>15分、有意识障碍、晚发型VAP、HMGB1>45μg/L均为VAP患者并发耐药菌感染的危险因素。Objective:To analyze influencing factors of drug-resistant bacterial infection in patients with ventilator-associated pneumonia(VAP).Methods:The clinical data of 206 patients with VAP admitted to Xinxiang Central Hospital from October 2022 to October 2023 were retrospectively analyzed.They were divided into infection group(n=124)and non-infection group(n=82)according to whether they were complicated with drug-resistant bacteria infection during hospitalization.The clinical data of the two groups were compared.Logistic regression analysis was used to analyze the influencing factors of drug-resistant bacterial infection in the VAP patients.Results:There were no significant differences in gender,hospitalization time,indwelling gastric tube,combined hypertension,combined coronary heart disease and glucocorticoid application between the two groups(P>0.05).There were significant differences in age,body mass index,antibiotic use time,ventilator use time,tracheal intubation,combined chronic obstructive pulmonary disease,combined diabetes mellitus,combined use of antibiotics,acute physiology and chronic health status scoring systemⅡ(APACHEⅡ)score,disturbance of consciousness,late-onset VAP and high mobility group protein B1(HMGB1)between the two groups(P<0.05).Logistic regression analysis showed that antibiotic use time>8 d,ventilator use time>10 d,multiple tracheal intubation,combined chronic obstructive pulmonary disease,combined diabetes mellitus,combined use of antibiotics,APACHEⅡscore>15 points,disturbance of consciousness,late-onset VAP,HMGB1>45μg/L were risk factors for drug-resistant bacteria infection in the VAP patients(OR>1,P<0.05).Conclusions:The antibiotic use time>8 d,ventilator use time>10 d,multiple tracheal intubation,combined chronic obstructive pulmonary disease,combined diabetes mellitus,combined use of antibiotics,APACHEⅡscore>15 points,disturbance of consciousness,late-onset VAP,HMGB1>45μg/L are the risk factors for drug-resistant bacteria infection in the VAP patients.

关 键 词：呼吸机相关性肺炎 耐药菌感染 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]