【摘要】 目的分析多重耐药鲍曼不动杆菌(multidrug-resistant acinetobacter Baumannii,MDRAB)感染重症肺炎患者的临床特点、预后的相关危险因素。方法选取诊断明确的MDRAB感染重症肺炎患者60例,分为存活组31例及死亡组29例进行比较,采用单因素分析和多因素Logistic回归分析找出感染重症肺炎患者预后相关的危险因素。结果死亡组年龄较大,APACHEⅡ评分较高,血清降钙素原(procalcitonin,PCT)较高,72h内累积液体正平衡患者及机械通气患者更多(P<0.05),而2组白细胞计数和C反应蛋白差异无统计学意义(P>0.05)。Logistic回归分析显示PCT升高、需要接受机械通气及72h内液体正平衡为MDRAB感染重症肺炎患者预后不良的危险因素。结论死亡组患者具有高龄、APACHEⅡ评分高、PCT升高、72h内液体正平衡及需要接受机械通气等特点。PCT升高、需要接受机械通气及72h内液体正平衡是MDRAB感染重症肺炎患者预后不良的危险因素。更多还原

【Abstract】 Objective To analyze the clinical features in patients with severe pneumonia infected by multiple drug resistant acinetobacter baumannii(MDRAB),and to explore the risk factors associated with the prognosis.Methods The data of 60 patients with severe pneumonia caused by MDRAB in intensive care unit(ICU)were retrospectively analyzed.The patients were divided into survival group and death group.The clinical characteristics of the two groups were compared by single factor analysis and logistic regression analysis.Results Univariate analysis suggested that age,APACHE II score,PCT,positive balance of fluid accumulation in 72 hours and mechanical ventilation may be associated with poor prognosis(P<0.05),but there were no significant difference in white blood cell count and CRP between two groups.Logistic regression analysis showed that PCT elevation,the need for mechanical ventilation and 72 hliquid positive balance may be the independent risk factors for the poor prognosis.Conclusion Advanced age,high APACHE II score,PCT elevation,need for mechanical ventilation and positive balance offluid accumulation in 72 hours were the independent risk factors for poor prognosis in the patients with severe pneumonia caused by MDRAB.更多还原