肺结核并发肺部感染的危险因素分析

Risk factors of pulmonary tuberculosis complicated with pulmonary infection

目的探讨肺结核患者并发肺部感染的相关危险因素及病原菌特点。方法选取2017年3月-2019年3月我院收治的179例肺结核患者作为研究对象,观察患者并发肺部感染情况。采集肺部感染患者肺泡灌洗液、痰液等标本进行病原菌分离鉴定;采用Logistic回归分析影响肺结核患者并发肺部感染的相关危险因素。结果179例肺结核患者中肺部感染82例,感染率为45.81%。Logistic回归分析显示,病程≥4年、合并糖尿病、长期使用糖皮质激素、长期使用广谱抗生素、复治肺结核和侵入性操作为影响肺结核患者并发肺部感染的危险因素。82例肺部感染患者分离病原菌83株,以革兰阴性菌为主,共58株,占69.88%。结论肺结核患者并发肺部感染以革兰阴性菌为主,病程≥4年、合并糖尿病、长期使用糖皮质激素、长期使用广谱抗生素、复治肺结核和侵入性操作为影响肺结核患者并发肺部感染的危险因素。

Objective To explore the risk factors and pathogenic bacteria characteristics of pulmonary tuberculosis patients complicated with pulmonary infection.Methods A total of 179 patients with pulmonary tuberculosis admitted to our hospital from March 2017 to March 2019 were included in this study and observed for concurrent pulmonary infection.Pulmonary alveolar lavage fluid and sputum samples from patients with pulmonary infection were collected for pathogenic bacteria isolation and identification.Logistic regression analysis was used to analyze the risk factors of pulmonary infection in patients with pulmonary tuberculosis.Results Among 179 cases of pulmonary tuberculosis,82 cases had pulmonary infection,the infection rate was 45.81%.Logistic regression analysis showed that duration of disease≥4 years,concurrent diabetes mellitus,long-term use of glucocorticoids,long-term use of broadspectrum antibiotics,retreatment of pulmonary tuberculosis and invasive operation were risk factors for pulmonary infection in pulmonary tuberculosis patients.There were 83 strains of pathogenic bacteria isolated from 82 patients with pulmonary infection,mainly Gramnegative bacteria,totally 58 strains,accounting for 69.88%.Conclusions Pulmonary infections in pulmonary tuberculosis patients are mainly caused by Gram-negative bacteria.The duration of disease≥4 years,concurrent diabetes mellitus,long-term use of glucocorticoids,long-term use of broad-spectrum antibiotics,retreatment of pulmonary tuberculosis and invasive operation are risk factors for pulmonary infection in pulmonary tuberculosis patients.