心血管病住院患者并发肺部感染的原因与对策

Causes and countermeasures for pulmonary infections in hospitalized patients with cardiovascular diseases

目的探讨心血管病住院患者并发肺部感染的原因与对策,为防治肺部感染提供临床参考。方法共纳入102例心内科住院合并有肺部感染患者,同时纳入100例心内科住院未合并有肺部感染发生患者,详细记录患者的相关信息,应用非条件logistic回归分析进行多因素分析。结果两组患者治疗后,心血管疾病症状稳定好转;肺部感染患者治疗后体温、血常规白细胞水平下降,咳嗽、咳痰等症状减轻,肺部啰音基本消失,X线示肺部炎症也明显好转;感染组≥65岁、患有慢性阻塞性肺疾病(COPD)、合并心力衰竭、卧床分别占60.8%、51.0%、50.0%、35.3%,非感染组分别占43.0%、26.0%、30.0%、18.0%,两组比较差异有统计学意义(P<0.05);进一步行多因素分析结果表明,年龄≥65岁、COPD病史、合并心力衰竭卧床是心力衰竭患者发生肺部感染的独立危险因素。结论年龄≥65岁、COPD病史、合并心力衰竭、卧床是心力衰竭患者发生肺部感染的独立危险因素,对该类人群的相关危险因素采取相应的对策具有重要的意义。

OBJECTIVE To explore the causes and countermeasures for the pulmonary infections in the hospitalized patients with cardiovascular diseases so as to provide reference for clinical prevention and treatment of pulmonary infections.METHODS A total of 102 hospitalized patients with pulmonary infections in the cardiology department were enrolled in the study,meanwhile,100 patients without pulmonary infections were recruited,the relevant information of the patients was recorded,the multivariate analysis was performed by using non-conditional logistic regression analysis.RESULTS After the treatment in the two groups,the cardiovascular disease symptoms were improved and stable,the body temperature and routine blood WBC levels of the patients with pulmonary infections dropped,and the symptoms such as cough and expectoration decreased,the pulmonary rales almost disappeared,X-ray revealed that the pulmonary inflammatory was also significantly improved.In the infection group,the patients with the age more than 65 years accounted for 60.8%,the patients with COPD accounted for 51.0%,the patients complicated with heart failure accounted for 50.0%,and the bedridden patients accounted for 35.3%,significant higher than those of the non-infection group,which were 43.0% of the patients with more than 65 years of age,26.0% of the patients with COPD,30.0% of the patients with heart failure,and 18.0% of bedridden patients,the differences were statistically significant（P0.05）.The multivariate analysis showed that more than 65 years of age,COPD history,heart failure,and bedridden were the independent risk factors for the pulmonary infections in the patients with cardiovascular diseases.CONCLUSION More than 65 years of age,COPD history,heart failure,and bedridden are the independent risk factors for the pulmonary infections in the patients with heart failure.It is of great significance to take the corresponding countermeasures in response to the risk factors.