支气管扩张症患者感染铜绿假单胞菌危险因素分析

Analysis of risk factors for bronchiectasis infection with Pseudomonas aeruginosa

目的探讨支气管扩张症患者感染铜绿假单胞菌的危险因素,为支气管扩张症患者感染铜绿假单胞菌防治提供依据。方法对我院呼吸与危重症医学科2014年10月至2016年10月期间住院的支气管扩张症患者临床资料进行回顾性分析,以发生铜绿假单胞菌感染的病例为观察组,未发生铜绿假单胞菌感染的病例为对照组,采用单因素分析和logistics回归方法,分析支气管扩张患者感染铜绿假单胞菌的危险因素。结果共纳入422例支气管扩张症患者进入分析,其中感染铜绿假单胞菌组79例,单因素分析显示:女性、患病时间长、既往相关病史、吸烟史、支气管扩张影像学类型、支气管扩张CT评分高、动脉血二氧化碳分压(PaCO2)水平高、近3个月使用广谱抗生素、近1个月口服糖皮质激素、平均住院天数长、过去1年是否发生支气管扩张急性加重,过去1年支气管扩张急性加重次数以及过去1年内因支气管扩张导致的住院次数是支气管扩张患者感染铜绿假单胞菌的相关危险因素(P<0.05);Logistics回归分析发现:支气管扩张CT评分高、过去1年内是否发生急性加重,过去1年内急性加重的次数和过去1年内因支气管扩张导致的住院次数是支气管扩张患者感染铜绿假单胞菌的独立危险因素(P<0.05)。结论支气管扩张CT评分高、过去1年的发生急性加重情况及过去1年因支气管扩张住院次数是支气管扩张患者发生铜绿假单胞菌感染的重要危险因素,可采取针对性的防治措施改善该类患者的预后。

Objective To investigate the risk factors of Pseudomonas aeruginosa infection in bronchiectasis patients,and provide evidence for preventing the infection of Pseudomonas aeruginosa in patients with bronchiectasis.Methods We retrospectively analyzed the clinical data of inpatients with bronchiectasis from October 2014 to October 2016 in our Department of Respiratory and Critical Care Medicine.The patients with Pseudomonas aeruginosa infection were selected as observation group,while the patients without Pseudomonas aeruginosa infection were used as control group.The risk factors of Pseudomonas aeruginosa infection in patients with bronchiectasis were analyzed by univariate analysis and logistics regression.Results A total of 422 patients with bronchiectasis were included in the study,79 of them were infected with Pseudomonas aeruginosa.Univariate analysis showed the risk factors associated with infection of Pseudomonas aeruginosa in bronchiectasis patients(P<0.05)including woman,duration of disease,history of previous related diseases,smoking history,imaging types of bronchiectasis,and high CT score of bronchiectasis,high arterial blood PaCO2 level,use of broad-spectrum antibiotics in recent three months,oral glucocorticoid in recent January,more average hospitalization days,whether acute exacerbation of bronchiectasis occurred in the past year,the acute exacerbation times of bronchiectasis in the past year and the number of hospitalizations caused by bronchiectasis in the past year.And logistics regression analysis showed that CT score of bronchiectasis and whether acute exacerbation occurred in the past year or not,the frequency of acute exacerbation in the past year and the number of hospitalizations caused by bronchiectasis in the past year were independent risk factors for infection of Pseudomonas aeruginosa in bronchiectasis patients(P<0.05).Conclusions CT score of bronchiectasis,acute exacerbation in the past year and hospitalization due to bronchiectasis in the past year are important risk factors for Pseudomonas aeruginosa infection in patients with bronchiectasis.Targeted measures should be taken to improve prognosis in these patients.