社区与医院获得性肺炎危险因素对比分析

Comparative analysis on risk factors of community acquired and hospital acquired pneumonia

目的探讨社区获得性肺炎(CAP)与医院获得性肺炎(HAP)危险因素的差异,为防制突发公共卫生事件提供科学依据。方法连续收集山西医科大学第一附属医院2008年5月-2009年10月肺炎病例244例肺炎病例,筛检其中社区获得性肺炎178例,医院获得性肺炎66例,对比分析2组病例危险因素的差异。结果单因素分析结果显示,2组人群在性别(χ2=5.524,P=0.019)、年龄(χ2=18.355,P<0.001)、受教育程度(χ2=19.711,P<0.001)、基础疾病(χ2=5.384,P=0.016)、被动吸烟(χ2=5.935,P=0.015)和肺炎病人或呼吸道感染病例接触史(χ2=48.641,P<0.001)方面差异有统计学意义,而在职业、吸烟、饮酒和外出旅游史方面差异均无统计学意义,多因素分析结果显示,年龄大(OR=1.541,P=0.002)、高中学历(OR=0.217,P=0.008)、有基础疾病(OR=0.365,P=0.006)、居住在外市(OR=0.424,P=0.039)差异有统计学意义。结论社区获得性肺炎与医院获得性肺炎危险因素不同,应采取不同的防制措施。

Objective To discover differences in risk factors of community acquired pneumonia and hospital acquired pneumonia and to provide the scientific basis for public health emergency control.Methods Pneumonia cases were collected consecutively in the First Hospital of Shanxi Medical University from May 2008 to October 2009.A total of 244 cases of pneumonia were collected with 178 cases of community acquired pneumonia and 66 cases of hospital-acquired pneumonia.Then risk factors were compared between the two groups.Results Univariate analyses showed that the two groups were significantly different in gender,age,education level,underlying disease,passive smoking,and history of exposure to respiratory tract infection.But there was no significant difference in occupation,smoking,drinking,and travel history.Multivariate analyses showed that the difference was significant in age,education level,underlying disease,and geographic distribution.Conclusion There are different risk factors between community-acquired pneumonia and hospital-acquired pneumonia and control measures should be taken in different ways.