453例慢性心力衰竭患者下呼吸道感染现状及危险因素  

Status and risk factors of lower respiratory tract infection in 453 patients with chronic heart failure in a hospital

作　　者：张倩 韩建妙[1] 安然 朱娜娜 索玲 解琳琳 ZHANG Qian;HAN Jianmiao;AN Ran;ZHU Nana;SUO Ling;XIE Linlin(Department of Geriatrics,Shijiazhuang Third Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市第三医院老年医学二科,河北石家庄050000

出　　处：《公共卫生与预防医学》2025年第3期150-153,共4页Journal of Public Health and Preventive Medicine

基　　金：石家庄市科学技术研究与发展计划(211460413)。

摘　　要：目的 探讨慢性心力衰竭(chronic heart failure,CHF)患者发生下呼吸道感染(lower respiratory tract infection,LRTI)的现状及其危险因素分析。方法 对2022年6月至2024年2月期间收治的453例CHF患者进行回顾性分析,依据患者是否出现LRTI将其分为感染组和非感染组。通过收集痰液样本进行病原菌鉴定,同时收集患者的临床资料,采用logistic回归分析LRTI的危险因素。结果 453例患者中有78例(17.22%)发生LRTI,感染病原菌主要为革兰阴性菌。单因素分析表明,两组患者的年龄、心功能分级、住院时间、机械通气、合并COPD、抗生素使用比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄≥60岁(OR:1.581,95%CI:1.041~2.400)、心功能分级Ⅲ级和Ⅳ级(OR:1.948,95%CI:1.222~3.106)、行机械通气(OR:1.275,95%CI:1.024~1.588)、合并COPD(OR:1.684,95%CI:1.066~2.658)均为CHF患者发生LRTI的独立危险因素(P<0.05)。结论 CHF患者发生LRTI风险较高,主要为大肠埃希菌和肺炎克雷伯菌等革兰阴性菌,年龄≥60岁、心功能分级为Ⅲ级和Ⅳ级、机械通气使用及合并COPD是CHF患者发生LRTI的独立危险因素。Objective To investigate the status and risk factors of lower respiratory tract infection(LRTI) in patients with chronic heart failure(CHF).Methods A total of 453 CHF patients admitted from June 2022 to February 2024 were retrospectively analyzed.The patients were divided into infection group and non-infection group according to whether LRTI occurred.Sputum samples were collected for pathogen identification,and clinical data were collected.Logistic regression was used to analyze the risk factors of LRTI.Results Among the 453 patients investigated in this study,78 cases(17.22%) had LRTI,and the pathogens were mainly Gram-negative bacteria.Univariate analysis showed that there were statistical differences in age,cardiac function grading,hospitalization time,mechanical ventilation,concurrent COPD and antibiotic use between the two groups(P<0.05).Multivariate logistic regression analysis showed that age ≥60 years(OR:1.581,95%CI:1.041-2.400),cardiac function grade Ⅲ and Ⅳ(OR:1.948,95%CI:1.222-3.106),mechanical ventilation(OR:1.275,95%CI:1.024-1.588) and COPD(OR:1.684,95%CI:1.066-2.658) were independent risk factors for LRTI in CHF patients(P<0.05).Conclusion Patients with CHF have a high risk of LRTI,mainly caused by Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae.Age≥60 years old,cardiac function grade Ⅲ or Ⅳ,mechanical ventilation and concurrent COPD are independent risk factors for LRTI in CHF patients.

关 键 词：慢性心力衰竭 下呼吸道感染 危险因素 病原菌 

分 类 号：R181[医药卫生—流行病学]