急性心肌梗死医院感染特征及相关危险因素调查分析

Investigation on characteristics and correlated risk factors of hospital infection of acute myocardial infarction

目的探讨急性心肌梗死(AMI)医院感染的特征及其相关危险因素。方法回顾性分析424例AMI患者资料,依据是否发生医院感染分为感染组(56例)和未感染组(368例),采用单因素和多因素logistic分析法来筛选影响AMI医院感染的危险因素。结果 AMI患者医院感染率为13.2%(56/424),多数为呼吸道感染和泌尿系统感染;多因素分析显示,AMI医院感染的危险因素包括合并基础疾病(OR=4.802,95%CI:3.381~6.223,P<0.001)、心力衰竭(OR=2.565,95%CI:1.648~3.482,P=0.004)、侵入性操作(OR=5.618,95%CI:4.017~7.219,P=0.003)、使用呼吸机(OR=1.878,95%CI:1.213~2.542,P<0.001)及使用抗菌药物(OR=2.815,95%CI:1.657~3.973,P=0.019)。结论 AMI患者医院感染发生率较高,以呼吸道感染为主,应针对以上独立危险因素早期监测和防治,制订合理干预措施,从而降低医院感染发生率。

Objective To explore the characteristics and correlated risk factors of hospital infection of acute myocardial infarction. Methods Data of 424 cases with AMI were retrospectively analyzed,these cases were divided into the infection group（56 cases） and the non-infection group（368 cases） according to whether or not with hospital infection. Single factor and multiple risk factors methods were used to screen the risk factors of AMI hospital infection. Results The hospital infection rate of AMI was 13.2% （56/424）,mainly in respiratory system and urinary system. Multiple factors analysis result showed that these factors such as combination with basic diseases （OR = 4.802,95%CI：3.381 - 6.223,P〈0.001）,heart failure （OR = 2. 565,95%CI：1.648 - 3.482,P = 0.004）,invasive procedure （OR = 5.618,95% CI：4.017 - 7.219,P = 0.003）,use of respirator （OR = 1.878,95%CI：1.213 - 2.542,P〈0.001） and antibacterials （OR = 2. 815,95% CI：1. 657 - 3. 973,P = 0. 019） were the risk factors of hospital infection of AMI. Conclusion The hospital infection rate of AMI is high,mainly with respiratory tract infection. We should early monitor,prevent and treat the hospital infection to aim directly at these above independent risk factors,and formulate reasonable intervention measures,in order to cut down hospital infection rate of AMI.