慢性心衰合并肺部感染患者的感染原探讨.doc

慢性心衰合并肺部感染患者的感染原探讨 586 安徽医学 AnhuiMedicalJournal 第31卷第6期 2010年6月 慢性心衰合并肺部感染患者的感染原探讨 李荣成 [摘要]目的探讨各年龄组心功能不全住院患者合并肺部感染的病原学特征.方法根据528例因心功能不全住院患 者合并肺部感染的痰培养结果,分别统计各年龄组的阳性率及病原学分布情况,并在各年龄组问进行比较,观察其差异有无统计学 意义.结果528例痰培养中,阳性者301例,阴性者227例,阳性率57.0%,其中G菌感染109例,占36%;G一菌感染48例,占 16%;真菌感染144例,达47.5%.阳性率有随年龄增高的趋势.60岁之前,各相邻组问差异无统计学意义,至75～89岁达高峰; 与青年组及中年组的相比差异有统计学意义(P均小于0.01),与老年组相比差异无统计学意义(Pgt;0.05).结论心衰患者肺部 感染的发生率有随年龄增加的趋势.其中G菌感染率随年龄增加而下降,真菌感染率随年龄增高而上升,G菌感染在各年龄组 间无明显差异. [关键词]心衰;肺部感染;痰培养;细菌;真菌 doi:10.3969/j.issn.1000—0399.2010.06.012 Etiologyresearchforchronicheartfailurepatientswithpulmonaryinfectionofmerger LiRongcheng LuanMunicipalHospita1.M,n237000.China [Abstract]0bjectiveToreserchtheetiologycharacteristicsofallagegroupsofhospitalizedpatientswithheartfailureandpulmo— naryinfection.MethodsAccordingto528hospitalizedpatients(male:311;female:217)withcardiacdysfunctionandpulmonaryinfection fromAugust2006toDecember2009,andtallyseparatelythedistributionofthepositiverateandetiologyfol’eachagegroup.Andhavecom— parisonsbetweenadjacentagegroupstoobservethec0nspicuousnessofthedifferences.ResultsOfthe528patiens,301patientsareposi— tiveandnegativein227cases.thepositiverateofsputumcultivationis57.O%.Amongwhichthereare109patientswithG+bacterialin— feetion,accountingfor36%;G—bacteriainfectionin48cases,16%;fungalinfectionin144cases,upto47.5%.Thepositiverateofspu— rumcultivationincreasedwithage.Therearenosignificantdifferencesamongeachadjacentgroupsbeforetheageof60,butitreachestoits peakbetween75to89yearsofage.ThedifferencebetweentheyounggroupandMiddle—agedgroupwassignificant(Plt;0.01).Compared withtheoldgroupshowednosignificantdifference(Pgt;0.05).G+bacterialinfectionaccountedfor:36%.G—bacteriainfectionaccoun— tedfor:16%,fungalinfectionsreached47.5%.ConclusionTheincidenceofpulmonaryinfectioninpatientswithheartfailurehasthe tendencytoincreasewithage,whileG+bacteriainfectionratesdeclinesasincreasingage,thefungalinfectionhasthetendencytoincrease withage.ThereisnosignificantdifferencesinG—bacteriainfec