老年脑梗死后肺部感染的病原菌特征及危险因素分析

Analysis of pathogenic bacteria characteristics and risk factors of pulmonary infection in elderly patients after cerebral infarction

目的 探讨老年脑梗死后肺部感染的病原菌特征及其发生的危险因素。方法 回顾性分析2020年1月—2023年12月于皖南医学院第二附属医院就诊的310例老年脑梗死患者临床资料,依据纳入患者是否继发肺部感染分成观察组(继发肺部感染)和对照组(未继发肺部感染)。统计310例脑梗死患者中肺部感染例数,并分析其病原菌特征。对2组临床资料进行单因素分析,并将其中有统计学意义的指标纳入二元Logistic回归分析中,得到老年脑梗死后肺部感染的危险因素。结果 310例脑梗死患者中,肺部感染87例,设为观察组,余下223例设为对照组。87例肺部感染患者分离病原菌菌株101株,其中革兰阴性菌占比最高69株,占比68.32%。通过对2组临床资料进行单因素分析及二元Logistic回归分析发现,老年脑梗死后肺部感染的独立危险因素有吸烟史、既往肺部疾病史、合并糖尿病、侵入性操作、后循环梗死、重度梗死及吞咽功能障碍。结论 老年脑梗死后肺部感染可能以革兰阴性菌为主,且与吸烟史、既往肺部疾病史、糖尿病、侵入性操作、梗死程度及吞咽功能有关,应及时采取临床干预措施。

Objective To explore pathogenic bacteria characteristics and risk factors of pulmonary infection in elderly patients after cerebral infarction.Methods The clinical data of 310 elderly patients with cerebral infarction who were treated in Second Affiliated Hospital of Wannan Medical College from January 2020 to December 2023 were retrospectively analyzed.They were divided into observation group(with secondary pulmonary infection)and control group(without secondary pulmonary infection)according to whether they had secondary pulmonary infection.The number of patients with pulmonary infection in 310 patients with cerebral infarction was counted and the characteristics of pathogenic bacteria were analyzed.Univariate analysis was conducted on clinical data of the two groups,and the statistically significant indicators were included in the binary Logistic regression analysis to identify the risk factors for pulmonary infection in elderly patients with cerebral infarction.Results Among 310 patients with cerebral infarction,87 cases who suffered from pulmonary infection were set as the observation group,and the remaining 223 ones were set as the control group.101 strains of pathogenic bacteria were isolated from 87 patients with pulmonary infections,of which 69 ones were Gram-negative,accounting for 68.32%.Univariate analysis and binary Logistic regression analysis found that smoking history,previous history of pulmonary diseases,diabetes,invasive operation,posterior circulation infarction,severe infarction and swallowing dysfunction were independent risk factors for pulmonary infection in the elderly patients after cerebral infarction.Conclusion The pulmonary infection in the elderly patients after cerebral infarction may be mainly caused by Gram-negative bacteria,and it is related to smoking history,previous history of pulmonary disease,diabetes,invasive operation,infarction degree and swallowing function.Therefore,clinical intervention measures should be taken in time.