摘要
目的 分析老年非小细胞肺癌(non-small cell lung cancer,NSCLC)放化疗患者发生下呼吸道感染的病原菌分布及危险因素.方法 采用回顾性分析,将我院108例行放化疗的老年NSCLC患者根据是否发生下呼吸道感染分为感染组(40例)和未感染组(68例),取分泌物作病原菌培养,同时对发生下呼吸道感染的相关因素进行单因素和多因素Logistic回归分析.结果 NSCLC患者下呼吸道感染发生率37.04％,感染率高于我院近年来医院感染平均水平(2019—2022年平均感染率分别为8.39％、8.05％、8.17％、7.04％).共培养分离出病原菌44株,革兰阴性菌占56.82％,革兰阳性菌占38.64％,真菌占4.55％.病原菌构成与我院总体病原菌构成无明显差异.感染组年龄≥70岁、合并糖尿病、TNM分期Ⅲ、Ⅳ期、住院时间>15 d、CD4+/CD8+比值≤1患者的比例均高于未感染组,差异有统计学意义(P均<0.05).年龄≥70岁、CD4+/CD8+比值≤1、住院时间>15 d、TNM分期Ⅲ、Ⅳ期为老年NSCLC放化疗患者发生下呼吸道感染的危险因素(OR=1.574、2.416、3.995、2.186,P<0.05).结论 我院老年NSCLC放化疗患者发生下呼吸道感染的病原菌谱近年来无明显变化,肺炎克雷伯菌和金黄色葡萄球菌占比较高.高龄、CD4+/CD8+比值降低、住院时间长及TNM分期高是患者发生下呼吸道感染的危险因素.
Abstract
Objective To analyze the distribution of pathogenic bacteria and risk factors of lower respiratory tract infection in elderly patients with non-small cell lung cancer ( NSCLC ) undergoing radiotherapy and chemotherapy. Methods A retrospective analysis was performed on 108 elderly NSCLC patients undergoing radiotherapy and chemotherapy in our hospital. According to whether they developed lower respiratory tract infection, they were divided into infection group ( 40 cases ) and non-infection group ( 68 cases ). Pathogenic bacterial cultures were performed on collected secretions. At the same time, data on the related factors of lower respiratory tract infection were collected, and conducted univariate and multivariate Logistic regression analyses. Results In NSCLC patients, the incidence of lower respiratory tract infection was 37.04％, which was higher than the average level of nosocomial infection in our hospital in recent years ( the average infection rates from 2019 to 2022 were 8.39％, 8.05％, 8.17％, and 7.04％, respectively ). The proportion of patients aged≥70 years, with diabetes, TNM stage Ⅲ and Ⅳ, hospitalization time >15 d, and CD4+/CD8+ ratio≤1 in the infection group was higher than that in the non-infection group, and the difference was statistically significant ( P<0.05 ). Age ≥70 years, CD4+/CD8+ ratio ≤1, hospitalization time >15 d, TNM stage Ⅲ and Ⅳ were the risk factors of lower respiratory tract infection in elderly NSCLC patients undergoing radiotherapy and chemotherapy ( OR=1.574, 2.416, 3.995, 2.186, P < 0.05 ). Conclusions The pathogenic bacterial spectrum of lower respiratory tract infection in elderly NSCLC patients undergoing radiotherapy and chemotherapy has no significant change in recent years. Old age, low CD4+/CD8+ ratio, long hospitalization time and high TNM stage are the risk factors of lower respiratory tract infection in patients.
基金项目
张家口市市级科技计划自筹经费项目(2022)(2221075D)
NETL
NSTL
万方数据