冠心病并发医院获得性肺炎的病原体分布特点及其相关因素研究

Pathogen Distribution and Related Factors of Coronary Heart Disease Complicated with Hospital Acquired Pneumonia

目的探讨冠心病并发医院获得性肺炎(HAP)患者的病原体分布特点,HAP对临床主要心血管不良事件影响及相关因素,以采取有效的控制措施。方法随机抽取2010年6月—2012年12月755例冠心病住院患者,并对其中36例并发HAP的患者进行回顾性分析。结果 36例并发HAP患者中,病原体为革兰阴性杆菌28株,占77.8%;住院期间主要心血管不良事件发生率为72.2%。不同年龄,是否行经皮冠状动脉介入治疗(PCI),是否有高血压、糖尿病、慢性阻塞性肺疾病(COPD)、营养不良及不同级别心功能冠心病患者HAP发生率比较,差异均有统计学意义(P<0.05)。结论冠心病并发HAP患者的病原体以革兰阴性杆菌为主,HAP影响冠心病患者原发病的康复,增加其临床主要心血管不良事件发生率。高龄、PCI,合并高血压、糖尿病、COPD、营养不良、心力衰竭是冠心病患者发生HAP的相关因素。

Objective TO investigate the pathogen distribution of coronary heart disease complicated with hospital, acquired pneumonia （HAP）, the influence of HAP on clinical cardiovascular events and related factors, and to take effective control measures. Methods 755 cases of inpatients with coronary heart disease were randomly selected from June 20i0 to De- cember 2012, and 36 cases of patients with HAP were retrospectively analyzed. Results In the 36 patients with HAP, 28 strains were gram negative bacilli （77. 8% ） ; The rate of hospital major adverse cardiovascular events was 72. 2%. The HAP rate were statistically significant in patients of different ages or cardiac function, whether underwent PCI, whether had hyperte/l- sion, diabetes, chronic obstructive pulmonary disease （ COPD）, malnutrition （P 〈 0. 05 ）. Conclusion Gram negative ba2 cilli is the main strain in the coronary heart disease compiicated with HAP, HAP effects the rehabilication of coronary heart dis- ease patients original onset of rehabilitation, increased its clinical cardiovascular event. Old, PCI, hypertension, diabetes, COPD, malnutrition, heart failure are related factors in patients with coronary artery disease complicated with HAP.