医院获得性肺炎与低磷酸盐血症的关系

Relationship between hypophosphatemia and clinical manifestation in patients with nosocomial pulmonary infection

目的 :探讨医院获得性肺炎的发生、发展及预后与低磷酸盐血症的关系 ,为该病的预防和治疗提供依据。方法 :分析67例医院获得性肺炎患者 (A组 )和 45例未发生医院肺部感染患者 (B组 )的血清磷酸盐水平及一系列生化指标 ;并以血清磷酸盐水平将医院获得性肺炎患者分为低磷酸盐血症组 (A1 )和非低磷酸盐血症组 (A2 ) ,比较两组患者的多项实验室生化指标、肺部感染吸收情况和病死率。结果 :A组入院时血清磷酸盐水平、血清钠、钾、氯和钙低于非医院获得性肺炎组 (P <0 .0 5) ;医院获得性肺炎发生时血清磷酸盐水平、血清钠、钾、钙、白蛋白、胆固醇低于入院时 ,碳酸氢根高于入院时 (P <0 .0 5) ;而B组入院时与住院期间比较 ,入院时只血碳酸氢根低于住院期间 ;A1 组血清钠、钾、钙、白蛋白及胆固醇低于A2 组 ,而碳酸氢根高于A2 组 (P <0 .0 5) ;另外 ,A1 组患者肺部感染吸收时间长、病死率高。结论 :低磷酸盐血症与医院获得性肺炎的发生。

Purpose:To investigate the factors closely associated with the progression and prognosis of nosocomial pulmonary infection. Methods:The laboratory data including serum phosphate obtained from 67 patients with nosocomial pulmonary infection (group A) and 45 hospitalized patients without pulmonary infection (group B)were analyzed. The nosocomial pulmonary infection patients were further divided into patients with hypophosphatemia (group A 1) and without hypophosphatemia (group A 2), the laboratory data, the resolution of pulmonary infection and mortality between gronp A 1 and group A 2 were compared. Results:The serum level of phosphate,sodium, potassium, chlorine,and calcium in group A patients were lower than those of group B patients( P <0.05). In group A patients, the serum level of phosphate, sodium, potassium,calcium, albumin and cholesteral were lower while bicarbonate were higher than those determined before the development of pulmonary infection( P <0.05); while in group B patients,only serum bicarbonate were getting lower. The serum level of sodium, potassium, calcium,albumin and cholasteral were lower while serum bicarbonate were higher in group A 1 patients than in group A 2 patients ( P <0.05). Besides, the resolution time of pulmonary infection in group A 1 patients were much longer and mortality were higher. Conclusions:Hypophosphatemia could be related to the development, progress and prognosis of nosocomial pulmonary infection.