| 段玉彩,魏亚君,郭 玲,赵 瑞,王 丽.急性心肌梗死合并肺部感染患者多药耐药菌分布特征及心肌酶谱指标与炎性因子的关系分析[J].,2019,19(18):3531-3535 |
| 急性心肌梗死合并肺部感染患者多药耐药菌分布特征及心肌酶谱指标与炎性因子的关系分析 |
| Distribution Characteristics of Multidrug-resistant Bacteria in Patients with Acute Myocardial Infarction Complicated with Pulmonary Infection and the Relationship between Myocardial Enzymes and Inflammatory Factors |
| 投稿时间：2019-01-21 修订日期：2019-02-20 |
| DOI：10.13241/j.cnki.pmb.2019.18.029 |
| 中文关键词: 肺部感染 心肌酶谱 急性心肌梗死 炎性因子 病原菌 耐药 |
| 英文关键词: Pulmonary infection Acute myocardial enzymes Myocardial infarction Inflammatory factors Pathogenic bacteria Drug resistance |
| 基金项目:全军军队医药卫生课题基金资助项目（LZ15GY127） |
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| 中文摘要: |
| 摘要 目的：分析急性心肌梗死合并肺部感染患者多药耐药菌分布特征及炎性因子与心肌酶谱指标的关系。方法：选择2015年2月~2018年10月期间中国人民解放军联勤保障部队第940医院收治的67例急性心肌梗死合并肺部感染患者作为感染组，选取同期收治的60例单纯急性心肌梗死患者作为未感染组，分析感染组多药耐药菌的分布及其耐药性，比较两组炎性因子与心肌酶谱指标水平，采用Pearson相关性分析感染组患者炎性因子与心肌酶谱指标的相关性。结果：67例患者痰培养标本中共分离出136 株病原菌，其中有64株属于多药耐药菌，多药耐药菌中革兰阴性菌38株，占59.37%，革兰阳性菌26株，占40.63%。其中主要革兰阴性菌对哌拉西林/舒巴坦、头孢哌酮/舒巴坦、阿米卡星、美罗培南、亚胺培南等较为敏感，主要革兰阳性菌对替考拉宁、万古霉素、利福平等较为敏感。感染组患者白细胞介素-6（IL-6）、乳酸脱氢酶（LDH）、促血管生成素-2（Ang-2）、肌酸激酶（CK）、肿瘤坏死因子-α（TNF-α）、谷草转氨酶（AST）、肌酸激酶同工酶（CKMB）水平均高于未感染组患者（P<0.05）。经Pearson相关性分析可得，感染组患者血清IL-6、Ang-2、TNF-α水平与AST、LDH、CK、CK-MB水平均呈正相关（P<0.05）。结论：急性心肌梗死合并肺部感染患者心肌酶谱与炎性因子水平关系密切，有助于判断患者病情严重程度，且急性心肌梗死合并肺部感染患者多药耐药现象较为严重，临床应针对病原菌合理选取抗菌药物。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the distribution of multidrug-resistant bacteria in patients with acute myocardial infarction complicated with pulmonary infection and the relationship between inflammatory factors and myocardial enzymes. Methods: 67 patients with acute myocardial infarction complicated with pulmonary infection who were admitted to 940 Hospital of PLA Joint Logistics Support Force from February 2015 to October 2018 were selected as infection group, and 60 patients with simple myocardial infarction who were admitted in the same period were selected as uninfection group. The distribution and drug resistance of multidrug-resistant bacteria in infection group were analyzed. The levels of inflammatory factors and myocardial enzymes were compared between the two groups. Pearson correlation was used to analyze the correlation between inflammatory factors and myocardial enzymes in patients with infection group. Results: A total of 136 pathogenic bacteria were isolated from sputum culture specimens of 67 patients. Among them, 64 strains belong to multi-drug resistant bacteria, 38 strains of Gram-negative bacteria account for 59.37%, 26 strains of Gram-positive bacteria account for 40.63%. Gram-negative bacteria were more sensitive to piperacillin/sulbactam, cefoperazone/sulbactam, amikacin, meropenem and imipenem. Gram-positive bacteria were sensitive to teicoplanin, vancomycin and rifampicin. The levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), angiopoietin-2 (Ang-2), creatine kinase (CK), tumor necrosis factor-α (TNF-α), aspartate aminotransferase (AST), creatine kinase isoenzyme (CKMB) in the infected group were higher than those in the uninfected group (P<0.05). According to Pearson correlation analysis, the serum levels of IL-6, Ang-2 and TNF-α were positively correlated with the levels of AST, LDH, CK and CK-MB (P<0.05). Conclusion: Myocardial enzymes of patients with acute myocardial infarction complicated with pulmonary infection is closely related to the level of inflammatory factors, which is helpful to judge the severity of patients'condition. Meanwhile, multidrug resistance in patients with acute myocardial infarction complicated with pulmonary infection is more serious, and antibiotics should be reasonably selected according to pathogenic bacteria in clinic. |
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