论文部分内容阅读
目的研究成人革兰阴性杆菌社区获得性肺炎(CAP)的临床特征及危险因素,为正确诊断革兰阴性杆菌CAP和合理应用抗菌药物提供理论依据。方法收集2003年9月～2009年9月间的CAP患者共552例。收集病人发病时的临床资料,取患者痰标本进行常规细菌培养,应用SPSS12.0对CAP危险因素进行单因素和多因素Logistic分析。结果 CAP患者中革兰阴性杆菌感染57例,占10.3%(57/552);单因素分析筛选出年龄≥65岁、合并支气管扩张、合并心衰、合并神经系统疾病、3月内应用抗菌药、呼吸频率>28次/min、中性粒细胞≥90%、BUN升高、PORT评分≥Ⅳ级等9个革兰阴性杆菌CAP可能危险因素。多因素分析筛选出合并支气管扩张症、合并神经系统疾病、呼吸频率>28次/min、中性粒细胞≥90%、3月内应用抗菌药等5个变量,可视为革兰阴性杆菌CAP的独立危险因素。结论革兰阴性杆菌感染在CAP占有一定比例,合并支气管扩张症、合并神经系统疾病、呼吸频率>28次/min、中性粒细胞≥90%、3月内应用抗菌药是革兰阴性杆菌CAP的独立危险因素。
Objective To study the clinical characteristics and risk factors of community-acquired pneumonia (CAP) in adults with Gram-negative bacilli and to provide a theoretical basis for the correct diagnosis of Gram-negative bacilli (CAP) and rational use of antibacterial drugs. Methods A total of 552 patients with CAP were collected from September 2003 to September 2009. The clinical data of patients at the time of onset were collected. The sputum samples of patients were collected for routine bacterial culture. Single factor and multivariate logistic analysis were used to analyze the risk factors of CAP using SPSS12.0. Results Fifty-seven patients (57/552) had Gram-negative bacilli infection in CAP patients. Single-factor analysis showed that patients older than 65 years old with bronchiectasis, complicated with heart failure and neurological diseases, and antibiotics , Respiratory rate> 28 beats / min, neutrophils ≥90%, elevated BUN, PORT score ≥ Ⅳ grade 9 gram-negative bacilli CAP may be risk factors. Multivariate analysis screened bronchiectasis, with neurological diseases, respiratory rate> 28 beats / min, neutrophils ≥ 90%, 3 months of the application of antibacterial and other 5 variables, can be considered as gram-negative bacilli CAP Of independent risk factors. Conclusion Gram-negative bacilli in CAP occupy a certain proportion, with bronchiectasis, with neurological diseases, respiratory rate> 28 beats / min, neutrophils ≥ 90%, antibacterial drugs in March is Gram-negative bacilli CAP Of independent risk factors.