| 张 培,蔺 昕,林 康,崔薇薇,黄晓沁.肺癌合并肺部感染患者病原菌分布、耐药性分析及血清炎性因子检测的临床意义[J].,2021,(9):1682-1686 |
| 肺癌合并肺部感染患者病原菌分布、耐药性分析及血清炎性因子检测的临床意义 |
| Clinical Significance of Pathogen Distribution, drug Resistance Analysis and Serum Inflammatory Factor Detection in Patients with Lung Cancer Complicated with Pulmonary Infection |
| 投稿时间：2020-08-26 修订日期：2020-09-21 |
| DOI：10.13241/j.cnki.pmb.2021.09.018 |
| 中文关键词: 肺癌 肺部感染 病原菌 耐药性 炎性因子 |
| 英文关键词: Lung cancer Pulmonary infection Pathogen Drug resistance Inflammatory factors |
| 基金项目:江苏省"科技兴卫工程"创新团队项目(LJ201133) |
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| 中文摘要: |
| 摘要 目的：探讨肺癌合并肺部感染患者病原菌分布、耐药性分析及血清炎性因子检测的临床意义。方法：选取我院于2018年6月~2020年3月期间收治的肺癌合并肺部感染患者90例为感染组，选取同期我院收治的肺癌未合并肺部感染患者100例为肺癌组，选取同期于我院进行体检的健康志愿者60例为对照组，对肺癌合并肺部感染患者的感染病原菌类型进行总结分析，分析常见病原菌药敏试验结果，统计病原菌耐药率。对比三组受试者的炎性因子水平。结果：90例肺癌合并肺部感染患者的送检痰液标本共检出100株病原菌，100株病原菌中以革兰阴性菌为主，其次为革兰阳性菌、真菌，分别占比63.00%、22.00%、15.00%。肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌对亚胺培南的耐药率较低，对氨苄西林、甲氨苄啶的耐药率均较高。凝固酶阴性葡萄球菌、金黄色葡萄球菌对万古霉素的耐药率较高，对左氧氟沙星的耐药率较低。白色念珠菌、热带念珠菌对两性霉素B、氟康唑、酮康唑、伊曲康唑的耐药率均较低。感染组、肺癌组的血清白介素-6（IL-6）、降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）水平均高于对照组，且感染组以上指标水平高于肺癌组（P<0.05）。结论：肺癌合并肺部感染患者体内病原菌种类繁多，对常见抗菌药物的耐药性存在差异，且患者体内存在较强的炎性反应，临床应根据药敏结果合理应用抗菌药物 。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical significance of the pathogen distribution, drug resistance analysis and serum inflammatory factor detection in patients with lung cancer complicated with pulmonary infection. Methods: From June 2018 to March 2020, 120 patients with lung cancer complicated with pulmonary infection in our hospital were selected as the infection group, 100 patients without lung cancer and pulmonary infection in our hospital as the lung cancer group, and 60 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The types of infection pathogens of lung cancer complicated with pulmonary infection patients were summarized and analyzed, the drug susceptibility test results of common pathogenic bacteria were analyzed, and the drug resistance rate of pathogenic bacteria was calculated. Inflammatory factors were compared in the three groups. Results: A total of 100 strains of pathogenic bacteria were detected in the sputum samples of 90 patients with lung cancer complicated with pulmonary infection. Among the 100 strains of pathogenic bacteria, gram-negative bacteria dominated, followed by gram-positive bacteria and fungi, accounting for 63.00%, 22.00% and 15.00%, respectively. Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa had lower drug resistance to imipenem, and higher drug resistance to ampicillin and trimethoprim. Coagulase-negative Staphylococcus and Staphylococcus aureus showed higher resistance to vancomycin and lower resistance to levofloxacin. The drug resistance rates of Candida albicans and Tropical candida to amphotericin B, fluconazole, ketoconazole and itraconazole were all low. The levels of interleukin-6(IL-6), calcitonin(PCT) and tumor necrosis factor-α (TNF-α) in the infection group and lung cancer group were all higher than those in the control group, and the levels of these indicators in the infection group were higher than those in the lung cancer group (P<0.05). Conclusion: There are many kinds of pathogenic bacteria in patients with lung cancer complicated with pulmonary infection, and there are differences in drug resistance to common antimicrobial agents, and there are strong inflammatory reactions in patients, so antimicrobial agents should be rationally applied in clinical practice according to drug sensitivity results. |
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