呼出气冷凝液pH值与迟发型VAP的相关分析

Relevance between pH value of exhaled breath condensate and late ventilator associated pneumonia

目的探讨呼出气冷凝液pH值水平与迟发型呼吸机相关性肺炎发生及严重程度的相关性。方法选取2009年5月-2011年4月在河北医科大学第二医院呼吸科ICU住院的迟发型呼吸机相关性肺炎患者57例及健康体检者60名;收集患者临床资料,计算临床肺部感染评分;并同步收集患者的呼出气冷凝液,测量pH值;之后行统计学分析。结果 57例迟发型VAP患者,有创机械通气期间下呼吸道分泌物共分离出病原菌173株,主要为铜绿假单胞菌及鲍氏不动杆菌,分别占24.86%及23.70%;迟发型VAP诊断当天呼出气冷凝液pH值较插管后第3天及健康对照组均有明显下降(t=5.802,P<0.05;t=12.146,P<0.05)。结论呼出气冷凝液pH值检测有助于迟发型VAP的诊治。

OBJECTIVE To find out and master the relevance between pH value of exhaled breath condensate（EBC） and late ventilator associated pneumonia（VAP）. METHODS A prospective study was conducted on 57 patients with late VAP hospitalized in ICU of Respiratory Department in the Second Hospital of Hebei Medical University from May 2009 to Apr.2011.Meanwhile,60 healthy cases were enrolled for control.The clinical data were collected to further calculate the pulmonary infection score（CPIS）.In the same time,EBC of all patients were collected to measure pH value.Then the statistical analysis was carried out. RESULTS One hundred and seventy-three pathogenic bacteria were isolated from the secretion of EBC of the 57 patients,which mainly were Pseudomonas aeruginosa and Acinetobacter baumannii,acounting for 24.86% and 23.70%,respectively.The pH value of EBC on diagnosis day of VAP declined obviously compaired with that on three days after tracheal intubation（t=5.802,P0.05）and that in healthy control group（t=12.146,P0.05）. CONCLUSION The detection of pH value of EBC is helpful for the diagnosis of late VAP.