老年急性呼吸衰竭合并肺部感染患者病原菌分布特点、心肌酶谱指标及炎性因子水平变化

Distribution of pathogenic bacteria,changes of myocardial enzymes and inflammatory factors in elderly patients with acute respiratory failure complicated with pulmonary infection

[背景]探讨老年急性呼吸衰竭合并肺部感染患者病原菌分布特点、心肌酶谱指标及炎性因子水平变化.[病例报告]选择自2021年12月至2023年12月间收治的120例老年急性呼吸衰竭患者作为研究对象,根据患者是否合并肺部感染分为肺部感染组39例和无肺部感染组81例.分析肺部感染组感染病原菌分布情况和病原菌耐药情况;比较两组患者心肌酶谱指标及炎性因子水平;分析肺部感染组患者心肌酶谱指标与炎性因子相关性.结果显示,肺部感染组39例患者痰标本中共培养出病原菌50株,其中革兰阳性菌10株(20.0%),革兰阴性菌36株(72.0%),真菌4株(8.0%);血清肌酸激酶(CK)、乳酸盐脱氢酶(LDH)、肌酸激酶同工酶(CKMB)、降钙素原(PCT)、C反应蛋白(CRP)水平均明显高于无肺部感染组(P<0.05).Pearson相关性分析结果显示,肺部感染组心肌酶谱指标CK、LDH、CKMB与炎性因子PCT、CRP均呈正相关(P<0.05).[讨论]老年急性呼吸衰竭合并肺部感染患者病原菌以革兰阴性菌为主,血清CK、LDH、CKMB、PCT、CRP水平均呈高表达,可作为疾病监测指标.

BACKGROUND To investigate the distribution of pathogenic bacteria,myocardial enzymes profile and inflammatory factors in elderly patients with acute respiratory failure complicated with pulmonary infection.CASE REPORTS 120 elderly patients with acute respiratory failure admitted from December 2021 to December 2023 were selected.They were divided into a lung infection group of 39 cases and a non lung infection group of 81 cases based on whether the patients were complicated with lung infection.Analyze the distribution and drug resistance of pathogenic bacteria in the lung infection group;Compare the myocardial enzyme spectrum indicators and inflammatory factor levels between the pulmonary infection group and the non pulmonary infection group;Analyze the correlation between myocardial enzyme spectrum indicators and inflammatory factors in lung infection groups.As a result,50 strains of pathogenic bacteria were cultured in sputum samples from 39 patients with concurrent pulmonary infections,including 10 strains(20.0%)of Gram positive bacteria,36 strains(72.0%)of Gram negative bacteria,and 4 strains(8.0%)of fungi.The serum creatine kinase(CK),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CKMB),procalcitonin(PCT),and C-reactive protein(CRP)in the lung infection group were all higher than those in the non lung infection group(P<0.05).The Pearson correlation analysis results showed that the myocardial enzyme spectrum indicators CK,LDH,CKMB in the lung infection group were positively correlated with inflammatory factors PCT and CRP(P<0.05).DISCUSSION Gram negative bacteria are the main pathogens isolated from elderly patients with acute respiratory failure and pulmonary infection.The serum CK,LDH,CKMB,PCT,and CRP levels of the patients are all highly expressed,and the above indicators can be used as disease monitoring indicators in clinical practice.