CAJ | 학술논문

目的分析因慢性阻塞性肺疾病急性加重(AECOPD)而频繁住院患者的病原学特征.方法自2007年1月至2008年12月在北京大学第三医院住院的AECOPD患者,病历明确记载AECOPD住院次数者入选.记录患者急性加重时的病原学分布、多重耐药菌感染情况.根据过去一年中因AECOPD而住院的次数把患者分为频繁住院组(住院次数≥2次)和非频繁住院组(住院次数＜2次)；比较2组病原菌分布及耐药情况.结果共172例患者获得完整资料,其中男134例；女48例.第1秒用力呼气量占预计值百分比为35％ (28％～45％).住院前1年因AECOPD住院情况:76例(44.2％)未因AECOPD住院；48例(27.9％)有1次因AECOPD住院；48例(27.9％)有2次因AECOPD住院.与非频繁住院组相比,频繁住院组患者更多地分离到非发酵革兰阴性菌[18.8％(9/48)比4.8％ (6/124),x2=6.756,P=0.009]、肠杆菌科细菌[18.8％ (9/48)比7.3％ (9/124),x2=4.877,P=0.027].频繁住院组多重耐药菌检出率显著高于非频繁住院组[25.0％(12/48)比8.1％(10/124),x2=8.898,P=0.003].结论 AECOPD患者感染细菌种类与AECOPD住院次数相关.
목적 분석인만성조새성폐질병급성가중(AECOPD)이빈번주원환자적병원학특정.방법 자2007년1월지2008년12월재북경대학제삼의원주원적AECOPD환자,병력명학기재AECOPD주원차수자입선.기록환자급성가중시적병원학분포、다중내약균감염정황.근거과거일년중인AECOPD이주원적차수파환자분위빈번주원조(주원차수≥2차)화비빈번주원조(주원차수＜2차)；비교2조병원균분포급내약정황.결과 공172례환자획득완정자료,기중남134례；녀48례.제1초용력호기량점예계치백분비위35％ (28％～45％).주원전1년인AECOPD주원정황:76례(44.2％)미인AECOPD주원；48례(27.9％)유1차인AECOPD주원；48례(27.9％)유2차인AECOPD주원.여비빈번주원조상비,빈번주원조환자경다지분리도비발효혁란음성균[18.8％(9/48)비4.8％ (6/124),x2=6.756,P=0.009]、장간균과세균[18.8％ (9/48)비7.3％ (9/124),x2=4.877,P=0.027].빈번주원조다중내약균검출솔현저고우비빈번주원조[25.0％(12/48)비8.1％(10/124),x2=8.898,P=0.003].결론 AECOPD환자감염세균충류여AECOPD주원차수상관.
Objective To analyze the distribution of pathogens and bacterial drug resistance for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients hospitalized frequently for AECOPD versus those with infrequent admissions.Methods A total of 172 patients admitted into Peking University Third Hospital for AECOPD from January 2007 to December 2008 were recruited.According to the frequency of AECOPD-related hospitalization during the previous year,they were divided into two groups of frequently hospitalized (≥2 hospitalizations due to AECOPD during the previous year) and infrequently hospitalized (＜ 2 hospitalizations due to AECOPD during the previous year).The distribution and drug resistance of pathogenic bacteria were compared between two groups.Results At the time of acute exacerbation,the frequently hospitalized patients had significantly higher rates of nonfermentative gram-negative bacteria (18.8％ (9/48) vs 4.8％ (6/124),x2 =6.756,P =0.009),enterobacteriaceae (18.8％ (9/48) vs 7.3％ (9/124),x2 =4.877,P =0.027) versus those infrequently hospitalized ones.The frequently hospitalized patients had more muhidrug resistant bacteria isolated from sputum versus those infrequently hospitalized ones (25.0％ (12/48) 比 8.1％ (10/124),x2 =8.898,P =0.003).Conclusion The distribution and drug resistance of pathogenic bacteria are associated with the frequency of AECOPD-related hospitalization during the previous year.