【摘要】 目的 探讨重症肺部感染患者肺泡灌洗液中病原菌分布情况及其对微炎症因子、肺功能的影响。方法 选取陕西省渭南市妇幼保健院2020年5月至2022年5月收治的100例重症肺部感染患者作为研究对象，所有患者均接受支气管肺泡灌洗检查。分析重症肺部感染患者肺泡灌洗液中病原菌分布情况、炎症因子[包括白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-10（IL-10）、肿瘤坏死因子（TNF-α）]水平、肺功能指标[第1秒用力呼气量（FEV₁）/预测值、FEV₁/用力肺活量（FVC）]水平及肺部感染严重程度[采用临床肺部感染评分（CPIS）评分进行评估]。结果 100例重症肺部感染患者的肺泡灌洗液经过病原菌培养基培养后，共检出病原菌100株，其中革兰阴性菌50株（50.00%）为革兰阴性菌组，革兰阳性菌41株（41.00%）为革兰阳性菌组，真菌9株（9.00%）为真菌组。革兰阴性菌组IL-6、IL-8、IL-10、TNF-α水平均较革兰阳性菌组和真菌组高（P<0.05）,且革兰阳性菌组IL-6、IL-8、TNF-α水平较真菌组高（P<0.05）。革兰阴性菌组FEV₁/预测值、FEV₁/FVC较革兰阳性菌组和真菌组低，而CPRIS评分较革兰阳性菌组、真菌组高，差异均有统计学意义（P<0.05）,且革兰阳性菌组FEV₁/预测值、FEV₁/FVC较真菌组低，而CPIS评分较真菌组高，差异均有统计学意义（P<0.05）。结论 重症肺部感染患者中感染革兰阴性菌最多，革兰阳性菌次之，真菌最少；感染革兰阴性菌患者的炎症因子水平最高、肺部感染最严重、肺功能最差。更多还原

【Abstract】 Objective To investigate the effects of distribution of pathogenic bacteria in the alveolar lavage fluid of patients with severe pulmonary infections and its effect on inflammatory factors and lung function.Methods A total of 100 patients with severe pulmonary infection admitted to Weinan Maternal and Child Health Hospital from May 2020 to May 2022 were selected as study subjects, and all patients received bronchoalveolar lavage examination.The distribution of pathogenic bacteria, the level of microinflammatory factors [including interleukin-6（IL-6）,interleukin-8（IL-8）,interleukin-10（IL-10）,tumor necrosis factor（TNF-α）],pulmonary function index [one-second expiratory volume（FEV₁）/predicted value, FEV₁/forced vital capacity（FVC）] and the severity of pulmonary infection [evaluated by the Clinical Pulmonary Infection Score（CPIS）] of the patients with severe pulmonary infections were analyzed.Results The alveolar lavage fluid of 100 patients with severe pulmonary infections was cultured with pathogenic bacteria media, and a total of 100 strains of pathogenic bacteria were detected, including 50 strains of Gram-negative bacteria（50.00%） as Gram-negative bacteria group, 41 strains of Gram-positive bacteria（41.00%） as Gram-positive bacteria group, and 9 strains of fungi（9.00%） as fungal group.The levels of IL-6,IL-8,IL-10 and TNF-α in the Gram-negative bacteria group were higher than those in the Gram-positive bacteria group and fungus group（P<0.05）,and the levels of IL-6,IL-8,IL-10 and TNF-α in the Gram-positive bacteria group were higher than those in the fungus group（P<0.05）.The FEV₁/predictive value and FEV₁/FVC in the Gram-negative bacteria group were lower than those in the Gram-positive bacteria group and fungi group, while the CPRIS score was higher in the Gram-positive bacteria group than that in the Gram-positive bacteria group and the fungi group, with statistically significant differences（P<0.05）;and the FEV₁/predicted value and FEV₁/FVC in the Gram-positive bacteria group were lower than those in the fungi group, while the CPRIS score in the Gram-positive bacteria group was higher than that in the fungi group, with statistically significant differences（P<0.05）.Conclusion Gram-negative bacteria is the most prevalent in patients with severe pulmonary infection, followed by Gram-positive bacteria and fungi; patients infected with gram-negative bacteria have the highest levels of inflammatory factors, the most severe lung infections, and the poorest lung function.更多还原