难治性哮喘患者肺泡灌洗液病原体培养结果的探讨

Discussion on the Results of Pathogen Culture of Pulmonary Alveolar Lavage Fluid in Patients with Refractory Asthma

目的探讨难治性哮喘合并肺泡感染患者肺泡灌洗液病原体培养结果。方法选入我院于2017年5月至2018年5月接收的难治性哮喘合并肺泡感染患者66例,设定为研究组。同时选取同时期来我院进行支气管肺泡灌洗测定66名人员为对照组,所有研究人员均予以支气管肺泡灌洗术测定。结果(1)研究组血清中炎性因子IL-6(59.90±6.35)pg/m L、IL-8(290.32±36.74)pg/m L低于BALF(108.32±18.45)pg/m L、(421.73±48.55)pg/m L;(2)66份肺泡灌洗液培养分离出病原菌98株,革兰阳性菌32株,革兰阴性菌62株,真菌4株;(3)化脓性链球菌、肺炎链球菌、金黄色葡萄球菌这三种对头孢类药物耐药率>50%;(4)绿脓杆菌、流感嗜血杆菌、肺炎克雷伯菌对替考拉宁、头孢噻吩耐药率>50%,流感嗜血杆菌对氨苄西林以及头孢曲松耐药率>30%,肺炎克雷伯菌对头孢曲松耐药率>30%。结论难治性哮喘合并肺炎感染患者血清以及BALF因子有所差异,BALF炎性因子以及病原菌测定对难治性哮喘合并肺部感染诊断有显著价值。

Objective To investigate the pathogen culture results of alveolar lavage fluid in patients with refractory asthma complicated with alveolar infection.Methods 66 patients with refractory asthma complicated with alveolar infection received in our hospital from May 2017 to May 2018 were selected as the study group.At the same time,66 people who came to our hospital for bronchoalveolar lavage were selected as the control group.All the researchers were given bronchoalveolar lavage.Results(1)IL-6(59.90±6.35)pg/mL and IL-8(290.32±36.74)pg/mL in the serum of the study group were lower than BALF(108.32±18.45)pg/mL and(421.73±48.55)pg/mL;(2)66 strains of alveolar lavage fluid culture isolate98 pathogenic bacteria,32 Gram-positive bacteria,62 Gram-negative bacteria,4 fungi;(3)S.pyogenes,S.pneumoniae,S.aureus The resistance rate of cephalosporins is>50%;(4)The resistance rate of Pseudomonas aeruginosa,Haemophilus influenzae,Klebsiella pneumoniae to teicoplanin,ceftiophene is>50%,Haemophilus influenzae to ampicillin and ceftriax Pine resistance rate>30%,Klebsiella pneumoniae resistance rate to ceftriaxone>30%.Conclusion There are differences in serum and BALF factors in patients with refractory asthma complicated with pneumonia infection.The determination of BALF inflammatory factors and pathogenic bacteria has significant value in the diagnosis of refractory asthma complicated with pulmonary infection.