抗精神病药物治疗致患者肺部感染的临床分析

Analysis on clinical types of pulmonary infections induced by antipsychotic medication

目的分析服用抗精神病药物并发肺部感染患者的临床特点及影响因素,为临床治疗提供参考依据。方法对2012年8月-2013年10月80例服用抗精神病药物并发肺部感染患者的临床资料进行回顾性分析,对感染类型、各型肺部感染的血常规特点、对症治疗时间进行对比,同时分析导致肺部感染的危险因素,采用SPSS19.0软件进行统计分析。结果细菌性肺炎及吸入性肺炎发病率较高,其次为支原体肺炎,其他类型肺炎较为少见;细菌性肺炎、吸入性肺炎及支原体肺炎患者中性粒细胞百分比均明显高于其他类型肺炎组患者(F=16.6134,P=0.0012),同时三者比较差异无统计学意义;吸入性肺炎治疗时间最长,其次为细菌性肺炎,其他类型肺部感染比较差异无统计学意义;经单因素及logistic多因素分析显示,年龄>42岁、白蛋白<40g/L、血钾<3.5mmol/L及NIHSS>35分为肺部感染发生的危险因素(P<0.05)。结论抗精神病药物并发肺部感染类型存在差异,临床治疗应注意对症治疗,同时也应注意年龄、营养摄入、血钾程度及NIHSS评分对肺内感染发生的影响。

OBJECTIVE To analyze clinical characteristics and influencing factors for pulmonary infections in patients receiving antipsychotic medication so as to provide reference for clinical treatment.METHODS Clinical data were retrospectively analyzed of 80 cases of antipsychotic medication complicated with pulmonary infections during Aug.2012 to Oct.2013.Characteristics of blood routine and symptomatic treatment time were compared by types of pulmonary infections,meanwhile,risk factors for pulmonary infections were analyzed.The software SPSS19.0was used for statistical analysis.RESULTS The incidence of bacterial pneumonia and aspiration pneumonia was relatively high,followed by Mycoplasma pneumonia,while the other types of pneumonia were rare.White blood cell count in routine blood test was significantly higher in the patients with bacterial pneumonia and aspiration pneumonia than in those with other types of pneumonia（F=21.4131,P=0.0001）,while the comparison between patients with the former three types was not significant.The treatment time for aspiration pneumonia was the longest,followed by bacterial pneumonia and the comparison to other types of pulmonary infections was not significant.The univariate and multivariate logistic analyse showed that age42years,albumin40g/L,serum potassium3.5mmol/L and NIHSS35 were risk factors for pulmonary infections（P〈0.05）.CONCLUSION As types of pulmonary infections induced by antipsychotic medication vary,clinicians should pay attention to symptomatic treatment as well as effects of age,nutrition intake,serum potassium level and NIHSS on pulmonary infections.