高血压、糖尿病、血脂异常及代谢综合征与超重和肥胖关系

目的 评估北京市农村居民体质指数(BMI)的分布,不同BMI居民高血压、糖尿病、血脂异常及代谢综合征患病率及其与超重和肥胖的关系.方法 对随机抽取的20 655名18～76岁农村居民进行横断面调查,通过问卷调查、体格检查和实验室检查收集资料进行分析.结果 北京市农村居民体重正常、超重和肥胖的年龄别标化率分别为68.1%,24.2%和7.7%.正常体重、超重、肥胖1～3级居民高血压患病率分别为14.4%,27.5%,34.8%,44.3%和50.7%,糖尿病患病率分别为2.9%,5.0%,6.4%,8.1%和11.2%.正常体重居民血脂异常患病率最低(13.8%),肥胖2级最高(35.1%).正常体重居民代谢综合征患病率最低(5.6%),肥胖3级居民最高(15.1%).超重和肥胖1～3级分别是正常体重患高血压危险的2.6、3.1、3.8和4.7倍,肥胖3级糖尿病(OR=4.5)和代谢综合征(OR=3.2)患病危险最高,肥胖2级血脂异常(OR=3.4)患病危险最高.结论 高血压、糖尿病、血脂异常和代谢综合征患病率随超重和肥胖级别增加而升高,超重和肥胖是高血压、糖尿病、血脂异常及代谢综合征的独立危险因素.     

膳食、体力活动与慢性病关系的研究

目的分析膳食、体力活动与慢性病的关系。方法利用2002年中国居民营养与健康状况调查中,随机抽取的天津市3673名样本人群数据,分析膳食结构和慢性病患病率以及膳食、体力活动与超重肥胖、高血压、糖尿病和血脂异常的相对危险度。结果天津市标化超重率为38.9%,肥胖率为26.8%,高血压患病率为30.7%,血脂异常患病率为32.2%,糖尿病患病率为3.7%。膳食结构中存在的主要问题为蔬菜、水果摄入不足,油、盐摄入量超标。膳食脂肪供能比≥30%和看电视≥3h/d是危险因素,超重肥胖、高血压、糖尿病和血脂异常的OR值分别为2.04(95%CI:1.53～3.04),2.00(95%CI:1.13～3.57),2.22(95%CI:1.66～2.98),1.64(95%CI:1.18～2.31);1.89(95%CI:1.32～2.70),1.79(95%CI:1.48～2.16),1.47(95%CI:1.33～1.78)和1.45(95%CI:1.28～1.65);体育锻炼≥30min/d是保护因素,其OR值分别为0.42(95%CI:0.28～0.68),0.60(95%CI:0.40～0.89),0.50(95%CI:0.35～0.80),0.61(95%CI:0.44～0.93);每天摄入蔬菜、水果≥500g可以预防肥胖和血脂异常,OR为0.60(95%CI:0.40～0.89)和0.47(95%CI:0.30～0.72)。结论天津调查对象的膳食结构、体力活动等行为因素与高血压等慢性病有很强的联系,应加强合理膳食、适当运动的健康促进,预防和控制慢性病。     

血脂异常和腹型肥胖的交互作用对糖尿病患病的关系研究

目的探讨血脂异常和腹型肥胖交互作用对糖尿病患病的影响,为糖尿病的防治提供科学依据。方法采取多阶段分层随机抽样对贵州省8个县/区的居民进行调查。采用Logistic回归分析影响糖尿病患病主要危险因素。采用Logistic回归相加尺度分析血脂异常和腹型肥胖交互作用对糖尿病患病的影响。结果贵州省成年居民糖尿病患病率6. 4%,调整年龄、城乡等混杂因素后,血脂异常和腹型肥胖均与糖尿病患病存在统计学关联(P 0.01)。交互作用分析显示,血脂异常和腹型肥胖与糖尿病患病存在协同的相加交互作用(RERI=1.74;95%CI:0.57~2. 90)。分层交互作用分析显示,仅在正常体质指数人群中,血脂异常和腹型肥胖与糖尿病患病存在协同的相加交互作用(RERI=2. 21; 95%CI:0.22~4. 20)。同时患有腹型肥胖与血脂异常的居民患糖尿病的风险更高(OR=4. 49, 95%CI:2.79~7. 21)。结论正常体质指数人群中血脂异常和腹型肥胖存在交互作用致使糖尿病患病风险显著提升,加强对居民特别是正常体质指数居民血脂和腰围的控制会有效降低糖尿病的患病风险。     

居民血脂异常影响因素的列线图分析

目的调查杭州市上城区居民血脂异常及影响因素,并建立列线图分析居民血脂异常风险。方法采用多阶段随机抽样方法,从上城区随机抽取5个街道,每个街道各抽取2个社区,每个社区抽取153户家庭,纳入家庭户中≥18岁居民进行问卷调查,体格检查和血糖、血脂检测;采用Logistic回归模型分析血脂异常的影响因素,并采用列线图分析血脂异常风险。结果有效调查3 061人,检出血脂异常536例,患病率为17.51%,标化患病率为13.74%。多因素Logistic回归分析结果显示,年龄≥45岁(OR45岁～=2.623, 95%CI:1.738～3.961; OR65岁～=3.941, 95%CI:2.632～5.900; OR75岁～=3.264, 95%CI:2.095～5.084)、超重/肥胖(OR=1.725, 95%CI:1.390～2.140)、糖尿病(OR=3.103,95%CI:2.369～4.063)、高血压(OR=2.789,95%CI:2.196～3.542)、有冠心病家族史(OR=2.215,95%CI:1.443～3.399)是血脂异常的危险因素;日常锻炼(OR=0.790,95%CI:0.630～0.991)是血脂异常的保护因素。建立的血脂异常风险列线图显示,年龄45～64岁为70分,65～74岁为100分,≥75岁为86分,患高血压为75分,患糖尿病为83分,有冠心病家族史为58分,日常不锻炼为17分,超重/肥胖为40分,总分0～373分,一致性指数C-index为0.790 (95%CI:0.779～0.801)。结论年龄≥45岁、超重或肥胖、患糖尿病、患高血压、有冠心病家族史和缺乏日常锻炼与血脂异常相关,根据上述影响因素建立的列线图对个体血脂异常风险有一定预测作用。     

江苏省老年人体质指数和腰围与主要慢性病的关系

目的探讨江苏省老年人体质指数(BMI)、腰围(WC)与高血压、血脂异常和糖尿病等常见慢性病的关系。方法利用江苏省2010年成人慢性病及其危险因素监测中≥60岁老年常住居民的数据,运用t检验或方差分析、偏相关分析和非条件logistic回归等方法,分析BMI、WC与血压、血脂和血糖及高血压、血脂异常和糖尿病等常见主要慢性病的关系。结果江苏省老年人肥胖、中心性肥胖和慢性病粗患病率分别为13.5%、54.3%和82.6%,患病率居于前3位的慢性病为高血压、血脂异常和糖尿病。BMI、WC均与收缩压(SBP)、舒张压(DBP)、TC、LDL-C、TG和FPG呈正相关,而与HDL-C呈负相关(P0.05)。肥胖、中心性肥胖、BMI和WC均与高血压、血脂异常和糖尿病显著相关,高血压、血脂异常和糖尿病患病风险随着BMI和WC的增加而不断升高(P0.05)。BMI每增加1个标准差(SD),高血压、血脂异常和糖尿病患病风险分别升高79%(OR=1.79,95%CI:1.61~2.00)、67%(OR=1.67,95%CI:1.52~1.84)和56%(OR=1.56,95%CI:1.38~1.76);WC每增加1个SD,高血压、血脂异常和糖尿病患病风险分别升高63%(OR=1.63,95%CI:1.47~1.80)、74%(OR=1.74,95%CI:1.58~1.91)和66%(OR=1.66,95%CI:1.46~1.89)。结论高血压、血脂异常和糖尿病是江苏省老年人常见主要慢性病。BMI、WC与高血压、血脂异常和糖尿病密切相关。     

丽水市区居民高血压患病及影响因素分析

目的 分析丽水市区居民高血压患病情况及影响因素.方法 采用多阶段整群随机抽样的方法,对2684名18岁以上居民进行现况调查.研究内容包括问卷调查,体格检查(身高,体重,腰围,血压)和实验室检查(空腹血糖,总胆固醇,高密度脂蛋白,低密度脂蛋白,甘油三脂). 结果丽水市区居民高血压粗患病率为33.1%,标化率为22.14%.男性高血压粗患病率为35.2%,标化率为26.10%;女性高血压粗患病率为31.6%,标化率为19.78%.多因素分析结果显示,高血压的影响因素包括血脂异常(OR=1.5, 95%CI 1.23~1.83),中心型肥胖(OR=1.29, 95%CI 1.01~1.66),超重和肥胖(OR=1.71, 95%CI 1.43~2.05),高血压家族史(OR=6.53, 95%CI 5.22~8.18),民族(OR=1.82, 95%CI 1.30~2.57),糖尿病(OR=1.31, 95%CI 1.00~1.71),年龄(OR=1.36, 95%CI 1.31~1.41). 结论丽水市市区居民高血压患病率较高,主要与血脂异常,糖尿病,中心型肥胖,超重和肥胖,遗传等因素有关.在老龄化社会的客观形势下,高血压综合防治工作中应在加强中老年人高血压三级预防的基础上,针对行为影响因素加强宣传教育与干预.     

江苏省社区居民吸烟与肥胖交互作用对血脂异常的关联分析

目的探讨吸烟与肥胖之间交互作用对血脂异常发病的影响。方法在江苏省6个项目实施地区中,共纳入35～75岁居民83 530人,使用国家心血管项目管理办公室统一设计问卷,以面访形式获取调查对象相关信息,并进行血压、身高、体重及腰围测量,采集空腹静脉血检测空腹血糖、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)。运用logistic回归模型分析血脂异常的危险因素,利用加法模型评价吸烟与肥胖的交互作用对血脂异常的影响。结果血脂异常患病率为37.16%,调整年龄、性别、文化程度、家庭收入、农民、婚姻状况等因素后,与对照人群相比,高血压(OR=1.43,95%CI:1.38～1.47)、吸烟(OR=1.06,95%CI:1.02～1.11)、肥胖(OR=1.09,95%CI:1.08～1.09)和糖尿病(OR=1.44,95%CI:1.39～1.49)是罹患血脂异常的危险因素。交互分析中,吸烟与肥胖对血脂异常的加法交互作用有统计学意义,两者同时存在时OR值为2.06(95%CI:1.90～2.24),SI值为2.33(95%CI:1.90～2.86)。结论吸烟与肥胖同时存在会增加血脂异常的患病风险,两者对血脂异常患病存在相加交互作用。     

潍坊市成人居民主要慢性病患病现状及其影响因素分析

目的 了解潍坊市成人居民慢性病患病现状及其影响因素,为慢性病预防与控制提供理论依据。方法 采用分层随机抽样方法在潍坊市抽取5 156名≥18岁成人居民进行问卷调查,利用logistic回归分析主要慢性病患病影响因素。结果 潍坊市成人居民高血压、血脂异常及糖尿病患病率分别为35.16%、34.60%、9.39%;对其影响因素进行logistic回归分析,多因素结果显示男性（OR = 1.391,95%CI:1.164～1.661）、年龄大（OR = 13.568,95%CI:8.215～22.408）、饮酒（OR = 1.270,95%CI:1.060～1.520）、肥胖（OR = 9.644,95%CI:5.203～17.878）、高盐（OR = 1.020,95%CI:1.000～1.041）、自评健康状况差（OR = 3.006,95%CI:1.694～5.335）、锻炼（OR = 0.834,95%CI: 0.725～0.959）是高血压的影响因素;男性（OR = 1.268,95%CI:1.032～1.558）、年龄大（OR = 6.049,95%CI:2.420～15.117）、肥胖（OR = 18.227,95%CI:2.471～134.480）、自评健康状况差（OR = 3.664,95%CI:1.093～12.277）、锻炼（OR = 0.719,95%CI:0.587～0.880）是糖尿病的影响因素;年龄大（OR = 2.209,95%CI:1.522～3.206）、自评健康状况好（OR = 0.859,95%CI:0.743～0.993）、已婚（OR = 0.599,95%CI:0.402～0.893）、肥胖（OR = 6.239,95%CI:3.868～10.062）、吸烟（OR = 1.281,95%CI:1.076～1.526）、高盐（OR = 1.024,95%CI:1.006～1.043）、高油（OR = 1.208,95%CI:1.007～1.014）是血脂异常的影响因素。结论 高血压、血脂异常和糖尿病是潍坊市成人居民的主要健康问题,其患病率随年龄呈上升趋势,应加强对老年人、超重和肥胖居民的健康管理,同时大力倡导低盐饮食,戒烟限酒,适度锻炼,提高居民生存质量。     

福州市鼓山镇老年2型糖尿病患病状况及其危险因素分析

目的 了解城乡结合部老年2型糖尿病的患病状况,为社区糖尿病干预提供基线数据.方法 2007年7-11月,采用随机整群抽样方法,抽取福州市城乡结合部鼓山镇14个行政单位60岁及以上常住居民4 653人进行2型糖尿病筛查.结果 鼓山镇老年2型糖尿病患病率为11.21%,经多因素非条件Logistic回归分析显示,年龄、职业、月收入(OR=1.42,95%CI:1.13～1.77)、糖尿病家族史(OR=6.49,95%CI:4.62～9.10)、向心性肥胖(OR=1.47,95%CI:1.15～1.88)是糖尿病患病的独立危险因素.结论 鼓山镇老年2型糖尿病患病率较高,今后应加强对有糖尿病家族史、向心性肥胖人群的健康教育及不良行为的干预,大力开展社区干预工作.     

肥胖与四种常见慢性病的相关性分析

目的分析肥胖与高血压、糖尿病、血脂异常和高尿酸血症的相关性,为防控慢性病提供依据。方法于2018年6—10月采用多阶段整群随机抽样方法,选取深圳市宝安区10个社区≥18岁的常住居民为调查对象,采用调查问卷收集基本人口学信息,测量身高、体重、血压和腰围,实验室检测空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和尿酸等生化指标。采用多因素Logistic回归模型分析肥胖与4种慢性病的关联。结果共调查宝安区常住居民2 004人,有效问卷1 994份,有效率为99.50%。宝安区成人超重、肥胖和中心性肥胖检出率分别为32.90%、9.03%和26.28%;高血压、糖尿病、血脂异常和高尿酸血症检出率分别为21.97%、5.97%、36.76%和13.24%。多因素Logistic回归分析结果显示,超重、肥胖均与高血压(OR:1.824～2.745,95%CI:1.350～4.338)、糖尿病(OR:1.725～3.267,95%CI:1.117～5.675)、血脂异常(OR:1.536～1.844,95%CI:1.201～2.796)和高尿酸血症(OR:2.089～2.773,95%CI:1.468～4.563)存在统计学关联;体重过轻与血脂异常(OR=0.418,95%CI:0.221～0.791)存在统计学关联;中心性肥胖与高血压(OR=1.651,95%CI:1.212～2.249)、糖尿病(OR=2.754,95%CI:1.863～4.070)、血脂异常(OR=1.884,95%CI:1.427～2.487)和高尿酸血症(OR=1.868,95%CI:1.325～2.633)均存在统计学关联。结论宝安区居民超重、肥胖和中心性肥胖情况不容乐观,肥胖与高血压、糖尿病、血脂异常和高尿酸血症均存在统计学关联。     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Bacteriology and constitutional health--genomics and proteomics: concepts in medicine and concepts in health insurance in the past and future

Future discussions on health issues on the individual or society level will be fundamentally linked to genetic dispositions. This genetic world will become reality in the same way the world of hygiene and bacteriology has become real for everyone. Approaches of molecular medicine for public health issues have not yet been created so far. The secret dreams of molecular eugenics must be made public and critically discussed. Up to now only a few monogenetically recessive hereditary diseases can be detected by screening. This kind of screening should be carefully considered. However, for the sciences, for medicine and thus for the physicians in practice, for health care sciences as well as for public health care, new tasks will emerge from genetics and molecular medicine. In individual as well as public health these new tasks will at first mainly turn in on the sphere of diagnosis and specific screening as well as health education and consultation. With regard to the considerable social implications the public health care sector should be aware of the coming issues of molecular medicine in time.     

成人社区及医院获得性肺炎病原菌及耐药性差异

 目的 比较非呼吸机相关医院获得性肺炎（NV-HAP）、呼吸机相关肺炎（VAP）与社区获得性肺炎（CAP）感染病原菌分布及耐药性。方法 回顾性调查2017年10月-2019年9月某院肺炎患者病历资料,按NV-HAP、VAP、CAP定义将患者分别列为NV-HAP组、VAP组、CAP组。收集三组患者痰、支气管肺泡灌洗液、血标本培养病原菌及药敏试验结果,分析三组患者感染病原菌构成和耐药性差异。结果 共纳入肺炎患者4 391例,NV-HAP组1 080例,VAP组126例,CAP组3 185例,各组分别检出病原菌841、191、1 440株,均以革兰阴性（G^-）菌为主,依次占72.77%、84.82%和61.18%,三组患者检出病原菌分布比较,差异有统计学意义（χ²=64.037,P<0.001）。鲍曼不动杆菌对头孢吡肟、头孢哌酮/舒巴坦、亚胺培南、庆大霉素、妥布霉素、左氧氟沙星、环丙沙星和复方磺胺甲口恶唑耐药率,铜绿假单胞菌对头孢哌酮/舒巴坦和亚胺培南耐药率,肺炎克雷伯菌对常用抗菌药物耐药率,三组比较差异均有统计学意义（均P<0.05）;金黄色葡萄球菌对红霉素、克林霉素和环丙沙星的耐药率比较,CAP组高于NV-HAP组（P<0.05）。结论 NV-HAP、VAP和CAP在病原菌分布及细菌耐药性方面均存在差异,在制定临床治疗方案时,要区别对待不同感染类型的肺炎。