【摘要】 目的探讨肺部感染患者住院期间发生急性左心力衰竭的危险因素,并采取相应的干预措施。方法回顾性分析2014年1月至2019年3月期间我院200例肺部感染住院患者的临床资料,根据患者住院期间是否发生急性左心力衰竭将其分为心衰组(35例)和非心衰组(165例),对肺部感染患者住院期间发生急性左心力衰竭因素进行单因素和多因素Logistic回归分析。结果 200例肺部感染患者的血培养致病菌阳性率为30.5%(61例),以革兰氏阴性菌和革兰氏阳性菌为主。单因素分析显示,急性左心力衰竭发作与年龄、 pro-BNP水平、心脏增大证据、高血压、心衰发作史或AMI史均有相关性(P <0.05),而与性别、糖尿病史、肾功能不全、联用抗生素、补液量无相关性(P>0.05)。Logicstics回归分析显示,年龄、补液速度、高血压、心衰发作史或AMI史是肺部感染患者发生急性左心力衰竭的相关危险因素(P <0.05)。监测pro-BNP水平,控制血压,对高龄、有心衰发作史或AMI史的患者注意利尿,控制补液速度,予以调节神经体液因素口服药为防止急性左心力衰竭发作的保护因素。结论肺部感染患者发生急性左心力衰竭的危险因素较多,主要为年龄、高血压、心衰发作史或AMI史、补液速度,临床上应采取相应措施预防肺部感染患者在住院期间发生急性左心力衰竭。更多还原

【Abstract】 Objective To explore the risk factors of acute left heart failure in patients with pulmonary infection during hospitalization and to take corresponding interventions. Methods The clinical data of 200 cases of hospitalized patients with pulmonary infection in our hospital from January 2014 to March 2019 were retrospectively analyzed. According to whether or not acute left heart failure occurred during hospitalization, the patients were divided into heart failure group(35 cases) and non-heart failure group(165 cases). The factors of acute left heart failure in patients with pulmonary infection during hospitalization were analyzed by univariate and multivariate Logistic regression analysis. Results The blood culture positive rate of 200 patients with pulmonary infection was 30.5%(61 cases), and the pathogenic bacteria were mainly Gram negative bacteria and Gram positive bacteria. Univariate analysis showed that the age, pro-BNP level,heart enlargement evidence, hypertension, and heart failure or AMI history were associated with acute left heart failure(P <0.05), but not associated with gender, diabetes history, renal insufficiency, combined antibiotics and fluid volume(P >0.05). Logicstics regression analysis showed the age, fluid infusion speed, hypertension, and heart failure or AMI history were risk factors for acute left heart failure in patients with pulmonary infection(P <0.05). Monitoring pro-BNP level, controlling blood pressure, and paying attention to diuresis of elderly patients with heart failure or AMI history, controlling fluid infusion speed, and giving oral drugs to regulate the neurohumoral fators were the protective factors to prevent the acute left heart failure. Conclusions Patients with pulmonary infection have many risk factors for acute left heart failure, mainly as age, hypertension, heart failure or AMI history, and fluid infusion speed. Clinically, corresponding measures should be taken to prevent patients with pulmonary infection from acute left heart failure during hospitalization.更多还原