住院阿尔茨海默病患者并发肺部感染危险因素

Risk factors of pulmonary infection in elderly hospitalized patients with Alzheimer’s disease

目的探讨阿尔茨海默病(AD)患者并发肺部感染的危险因素,为痴呆相关的肺炎提供防治参考。方法选取2020年1月-2020年12月在北京老年医院93例AD住院患者,根据是否合并肺部感染分为感染组52例和未感染组41例。感染组患者痰标本进行病原学检测,收集两组患者临床资料,分析肺部感染的危险因素。结果1年间93例AD住院患者并发肺部感染52例,感染率为55.91%。52例感染患者共分离出46株病原菌,其中革兰阴性菌37株占比80.43%,革兰阳性菌7株占比15.22%,真菌2株占比4.35%。单因素分析显示高龄、长期卧床、吞咽困难、有吸烟史、病程长、疾病程度严重的AD患者更易并发肺部感染(P<0.05),多因素结果显示有吸烟史、长期卧床是AD患者并发肺部感染的危险因素(P<0.05)。结论AD患者并发肺部感染的感染率较高,致病菌中以革兰阴性杆菌占主导地位。导致AD患者并发肺部感染的因素较多,对此类患者根据发病原因采取相应防治措施,可以减少临床患者并发肺部感染。

OBJECTIVE To investigate the risk factors of pulmonary infection in elderly hospitalized patients with Alzheimer’s disease(AD),and to provide reference for the prevention and treatment of dementia associated pneumonia.METHODS A total of 93 elderly patients with AD in Beijing Geriatic hospital from Jan.2020 to Dec.2020 were selected and divided into an infection group of 52 cases and a non-infected group of 41 cases according to whether they were complicated with pulmonary infection.The sputum specimens of the patients in the infection group were collected for pathogen detection,the clinical data of all patients were recorded,and the risk factors of pulmonary infection were analyzed.RESULTS During one year,52 of 93 hospitalized AD patients were complicated with pulmonary infection,and the infection rate was 55.91%.A total of 46 strains of pathogenic bacteria were isolated from 52 infected patients,of which 37 strains of gram-negative bacteria accounted for 80.43%.7 strains of gram-positive bacteria accounted for 15.22%,and 2 strains of fungi accounted for 4.35%.The univariate analysis showed that AD patients with advanced age,long-term bed rest,dysphagia,smoking history,long course of disease and severe dementia were more prone to pulmonary infection(P<0.05).Multivariate analysis showed that smoking history and long-term bed rest were the risk factors of pulmonary infection in AD patients(P<0.05).CONCLUSION The infection rate of pulmonary infection in elderly patients with AD was high,and gram-negative Bacilli were the predominant pathogens.The causes of pulmonary infection in elderly patients with AD were very complicated.Taking corresponding preventive measures for such patients according to the cause of the disease could reduce the incidence of pulmonary infection in patients with AD.