合并社区获得性肺炎的心力衰竭患者抗生素使用分析  

Analysis of Antibiotic Use in Patients with Community-Acquired Pneumonia and Heart Failure

作　　者：武思岐 韩逸初 任景怡[1] 

机构地区：[1]中日友好医院/北京协和医学院/中国医学科学院,北京

出　　处：《临床医学进展》2025年第2期2018-2027,共10页Advances in Clinical Medicine

摘　　要：背景:肺炎是诱发急性心力衰竭最常见的诱因之一,临床最常用的β酰胺类与喹诺酮类抗生素对于合并社区获得性肺炎的心力衰竭患者预后尚不清楚。本研究旨在比较两类抗生素对合并社区获得性肺炎的心力衰竭患者预后影响,并分析此类人群再住院相关的预测因子。方法与结果:本研究共纳入548例心力衰竭合并社区获得性肺炎患者。共有429例患者使用抗生素。此类人群最常用的抗生素分别为β内酰胺类(77.2%)、喹诺酮类(44.1%)、大环内酯类(11.7%)。根据单独使用β内酰胺类及喹诺酮类抗生素分组,106例单独使用β酰胺类(62.0%),65例单独使用喹诺酮类(38.0%)。两组患者基线特征平衡。logistic回归分析表明两种抗生素对合并社区获得性肺炎的心力衰竭患者30天内再入院或院内死亡的复合终点发生风险无差异(21.7% vs 13.8%, P = 0.205)。进一步多因素回归分析发现合并冠心病、肾功能不全、脑梗死的患者发生30天内再入院或院内死亡的风险分别是不合并上述并发症患者的7.48倍(OR: 7.48;95%CI: 2.03~27.59;P β内酰胺类及喹诺酮类抗生素对于合并社区获得性肺炎的心力衰竭患者预后无显著差异。合并冠心病、肾功能不全、脑梗死的患者预后更差,需要及早识别并积极治疗。Background: Pneumonia is one of the most common causes of acute heart failure. The prognosis for patients with heart failure who are also suffering from community-acquired pneumonia and are treated with the commonly used β-lactam and quinolone antibiotics is not well understood. This study aims to compare the impact of these two types of antibiotics on the prognosis of heart failure patients with community-acquired pneumonia and to analyze the predictive factors for readmission in this population. Methods and Results: A total of 548 patients with heart failure and community-acquired pneumonia were included in this study. Of these, 429 patients received antib

关 键 词：心力衰竭 社区获得性肺炎 抗生素 Β内酰胺类 喹诺酮类 

分 类 号：R54[医药卫生—心血管疾病]