摘要
目的探讨青少年与中老年急性脑血管疾病患者合并医院获得性肺炎(HAP)的临床特征和差异。方法回顾性分析医院急性脑血管疾病患者2237例,选取经临床症状、影像学和临床检验并明确病原体的医院获得性肺炎患者1569例,以≤30岁患者为青少年组,>30岁为中老年组。对两组患者年龄、性别、吸烟史、饮酒史、基础疾病史、住院天数和机械通气情况以及痰培养获得的病原体信息等进行记录和分析。结果中老年组患者男性比例、吸烟率、饮酒率、基础疾病罹患率、住院天数和机械通气率均明显高于青少年组患者,差异均有统计学意义(P<0.05)。青少年组患者革兰阳性菌稍多于革兰阴性菌;而中老年组革兰阴性菌明显多于革兰阳性菌,其中培养出≥2种病原菌者较多;两组间各种病原菌阳性率差异均有统计学意义(P<0.05)。结论急性脑血管疾病随着年龄增加发病率升高,且并发HAP的患者比率也明显增加。>30岁急性脑血管疾病并发HAP患者比≤30岁患者男性比例、吸烟率和饮酒率更高,住院时间更长,合并有基础疾病者更常见,需要进行机械通气治疗的比率更大,病情更严重;同时还发现中老年急性脑血管疾病并发的HAP致病菌以革兰阴性菌更常见,多重感染的比例更高。
Objective To investigate the characters of hospital-required pneumonia （HAP） and its differences between adolescence and middle-to-elder patients with acute cerebrovascular disease. Methods 2237 patients with acute cerebrovascular disease were included in our current retrospective study. Among them, 1569 patients with hospital-required pneumonia （HAP） were quantified and chosen. These patients were divided into two groups, adolescence group and middle-to-elde：r group., by the age of 30-years old. The genders, smoking history, alcohol history, underlying diseases information, hospital days and mechanical ventilation history were recorded. Meanwhile, sputum culture results were also analyzed. Results The male/female rates, smoking rates, alcohol rates, underlying diseases rates, hospital days and mechanical ventilation rates in middle-to-elderly group were markedly higher than adolescence group. Meanwhile, as for sputum culture, gram-positive bacteria were slightly more than gram-negative bacteria in adolescence group. On the other hand, gram-negative bacteria were more common in middle-to-elderly group. Additionally, multiple pathogens rates in middle-to-elderly group were significantly higher than adolescence group. Conclusion Our current retrospective study found that the incidence of acute cerebrovascular disease and its complicated HAP incidences were increased with the ages. The male/female rates, smoking rates, alcohol rates, underlying diseases rates, hospital days and mechanical ventilation rates were all higher, and the state of HAP was more severe in patients with the age of more than 30-years old. Meanwhile, gram-positive bacteria were more common in adolescence patients, and gram-negative bacteria were more popular in middle-to-elderly patients. Furthermore, multiple pathogens rates were also higher in middle-to-elderly patients.
出处
《西部医学》
2015年第4期501-504,共4页
Medical Journal of West China
基金
河北省卫生厅重点科技研究计划(20130359)
关键词
急性脑血管疾病
医院获得性肺炎
痰培养
革兰阴性菌
革兰阳性菌
Acute cerebrovascular disease
Hospital-required pneumonia, Sputum culture
Gram-positive bacteria
Gram-negative bacteria
