急性心肌梗死患者主动脉内球囊反搏术后下呼吸道感染风险及与预后关系

Risk factors for lower respiratory tract infection and its relation to prognosis in patients with acute myocardial infarction received intra-aortic balloon pump counterpulsation

目的:探讨主动脉内球囊反搏(IABP)救治的急性心肌梗死(AMI)心源性休克患者发生下呼吸道感染的危险因素及对预后的影响。方法:回顾55例接受IABP治疗的AMI心源性休克患者,Logistic回归分析住院期间下呼吸道感染的危险因素,评估感染对预后的影响。结果:43.6%IABP治疗的AMI心源性休克患者发生下呼吸道感染,有创机械通气、输血(血液制品)、未预防性使用抗生素、深静脉置管者发生感染的机会比较大(P<0.05)。感染患者病死率明显高于非感染者(75.0%vs38.7%,P=0.007);心源性休克、感染性休克和多器官功能不全是下呼吸道感染患者主要的死因。结论:下呼吸道感染与有创通气、深静脉置管、输血或血液制品有关;预防性使用抗生素减少感染风险。

Objective：To explore the risk factors for lower respiratory tract infection in patients with acute myocardial infarction （AMI） complicated with cardiogenic shock treated by intra-aortic balloon pump （IABP）counterpulsation, as well as its effect on prognosis. Methods：The risk factors for lower respiratory tract infection in 55 patients with AMI complicated with cardiogenic shock receiving IABP were analyzed logistically, and the effect of infection on prognosis was evaluated. Results：With treatment of IABP, 43.6% of the patients developed lower respiratory tract infection. The chance of developing the infection was higher in patients experienced invasive ventilation, blood transfusion, deep vein catheterization and lack of prophylactic use of antibiotics （P〈0. 05）. The mortality was higher in patients with infection than those without infection （75. 0% vs 38.7% ,P = 0. 007）. Cardiogenic shock, septic shock and multiple organ dysfunction syndrome were the main causes of death for patients with infections. Conclusion： Invasive ventilation, deep vein catheterization and blood transfusion are positively associated with lower respiratory tract infection,while prophylactic administration of antibiotics may reduce respiratory tract infections.