生物膜表达水平与呼吸机相关性肺炎的预后相关性研究

Correlation between expression level of biofilm and prognosis of ventilator-associated pneumonia

目的研究生物膜表达水平与铜绿假单胞菌引起的呼吸机相关性肺炎患者预后的关系以及相关危险因素分析,从而指导临床改善患者预后。方法收集2013年1月-2014年12月医院铜绿假单胞菌致呼吸机相关性肺炎患者34例,采用结晶紫法测定细菌生物膜的表达;收集患者临床资料,包括生命体征、基础疾病、实验室检查、通气参数、治疗方案及预后。结果 34例患者中,生物膜高表达8例,低表达26例,两组之间死亡率差异无统计学意义;死亡11例;统计分析结果显示白细胞数、休克、意识状态、TPN膳食、预防性抗菌药物治疗在呼吸机相关性肺炎预后上差异有统计学意义(P<0.05)。结论生物膜表达水平与铜绿假单胞菌呼吸机相关性肺炎预后无显著相关性。白细胞数、休克、昏迷、TPN膳食、预防性抗菌药物治疗是呼吸机相关性肺炎患者的死亡相关危险因素。

OBJECTIVE To study the correlation between the expression level of biofilm and prognosis of patients with ventilator-associated pneumonia （VAP） induced Pseudomonas aeruginosa and analyze the related risk factors so as to improve the prognosis. METHODS A total of 34 patients with VAP caused by P. aeruginosa who were treated in the hospital from Jan 2013 to Dec 2014 were enrolled in the study, then the expression of bacterial bio- film was determined by using crystal violet method, and the clinical data were collected from the patients, inclu- ding the vital signs, underlying diseases, laboratory examination, ventilation parameters, treatment programs, and prognosis. RESULTS Of the 34 patients, 8 presented with high expression of biofilm, 26 presented with low expression, and there was no significant difference in the mortality rate between the two groups~ 11 patients died. The result of statistical analysis indicated that there was significant difference in the white blood cell counts, shock, consciousness state, TPN diet, or antibiotics prophylaxis for the prognosis of VAP. CONCLUSION There is no significant correlation between the expression level of biofilm and the prognosis of VAP caused by P. aerugi- nosa. The related risk factors for death of the patients with VAP include the white blood cell counts, shock, co- ma, TPN diet, and antibiotics prophylaxis.