心肌梗死患者感染的临床分析及干预措施

Clinical analysis of infections in myocardial infarction patients and intervention measures

目的探讨心肌梗死患者感染的影响因素,并采取相应的处理措施,以期提高临床治疗水平。方法随机选取2010年1月-2013年1月85例心肌梗死感染患者为研究对象,均予以抗感染及对症治疗,对其中难以控制的感染进行影响因素分析,采用SPSS13.0软件对数据进行统计分析,计数资料采用χ2检验进行单因素分析,然后将单因素中具有差异性的单因素进行二分类logostic多因素分析,以P<0.05为差异有统计学意义。结果心肌梗死患者发生感染的影响因素有年龄(>65岁)、住院时间长(>14d)、长期应用抗菌药物和激素(>15d)、侵入性操作、合并严重疾病、糖尿病、营养不良、肝肾功能不全、入住CCU等(P<0.05),而与患者性别、心脏左室功能分级、心肌梗死部位、吸烟、高血压病等无关;其中年龄(OR=6.474)、抗菌药物和激素应用(OR=4.795)、侵入性操作(OR=5.693)、合并严重疾病(OR=4.595)、糖尿病(OR=8.857)、营养不良(OR=5.547)、肝肾功能不全(OR=8.337)是高危险因素。结论心肌梗死感染难以控制的因素多样,应加强预防积极治疗原发疾病,才能控制感染的发生。

OBJECTIVE To explore the influencing factors for infections in patients with myocardial infarction and put forward corresponding treatment measures to improve the level of clinical treatment. METHODS A total of 85 myocardial infarction patients with infections, who were hospitalized from Jan 2010 to Jan 2013, were enrolled in the study, then all the subjects received the anti-infection therapy and synoptic treatment, the influencing factors for the infections were analyzed, the data were statistically analyzed with the SPSS13.0 software, the chi-square test was performed for the counting data, the univariate analysis was conducted, the dichotomous multivariate logistic analysis was performed for the single factor that has difference, and P^0.05 was defined as statistical significance. RESULTS The influencing factors for infections in the myocardial infarction patients included the age （more than 65 years）, length of hospital day （more than 14 days）, use of antibiotics and hormones （more than 15 days）, invasive operation, complication of severe disease, diabetes, malnutrition, liver and kidney dysfunction, and CCU stay （P%0.05） ; while the infections in the myocardial infarction patients were not related to the gender, left ventricular function classification, myocardial infarction site, smoking, or hypertension. The age （OR = 6. 474）, use of antimicrobial agents and hormone（OR--4. 795）, invasive operation （OR--5. 693）, complication of severe disease （OR=4. 595）, diabetes （OR=8. 857）, malnutrition （OR 5. 547 ）, and liver and kidney dysfunction （OR= 8. 337） were the high-risk factors. CONCLUSION There are a variety of risk factors for infections in the myocardial infarction patients. It is necessary to strengthen the prevention and treatment of primary diseases to control the infections.