降钙素原与乳酸在老年社区获得性肺炎患者预后评估中的应用

目的研究降钙素原(PCT)与乳酸对老年社区获得性肺炎患者的病情和预后的评估作用。方法 118例老年社区获得性肺炎患者,入院后给予PCT、乳酸等检查,并给予肺炎严重指数(PSI)评分。分别比较重症与非重症肺炎、死亡组和存活组PCT、乳酸和PSI的区别;分析PCT、乳酸与PSI的相关性。结果重症肺炎患者乳酸、PCT和PSI评分均大于非重症患者,死亡组乳酸、PCT和PSI评分均大于存活组(P<0.05);乳酸、PCT与PSI评分呈正相关(r=0.63,0.65,P<0.05)。结论 PCT和乳酸对老年社区获得性肺炎患者的预后和病情有评估作用,PCT和乳酸升高提示患者预后差。     

Comparison of the clinical features of invasive pneumococcal disease with those of pneumococcal pneumonia in adults

Background: Invasive pneumococcal disease (IPD) is an infectious disease where Streptococcus pneumoniae can be detected in the cerebrospinal fluid or blood.Methods: Eight patients presented to our hospital with adult IPD. We compared with 69 cases of pneumococcal pneumonia treated in our department between 2012 and 2014. None of the patients had a history of pneumococcal vaccine administration.Results: Hematological examination showed the platelet count was significantly lower and the serum C-reactive protein level was significantly higher in the IPD group. There was a significant difference in the use of a respirator and mortality in the IPD group. About antibiotics, Carbapenem and quinolone were used for the treatment of many patients in the IPD group. In the fatal three cases of IPD, the age of all members were 65 years or younger. Two of three had no underlying disease.Conclusion: IPD develops without elderly people and in those without underlying disease. Also, the patients who took a sudden course may result in death. In line with previous studies that have reported the effectiveness of the pneumococcal vaccine, our study findings emphasize the need of administering vaccination for prevention of IPD in person who was younger than 65 years old.     

性病门诊患者泌尿生殖道支原体感染调查及药敏分析

目的 了解STD门诊患者支原体感染率及对9种抗生素的敏感性.方法 用支原体培养试剂盒进行检测.结果 665例STD门诊患者支原体总感染率27.37%,Uu、Mh及混合感染的阳性率分别为20.15%、1.05%、6.17%.药敏示:多西环素、米诺环素、克拉霉素、交沙霉素对支原体的敏感性最好;分离株对司帕沙星、氧氟沙星、罗红霉素高度耐药.结论 广州地区泌尿生殖道的支原体感染首选米诺环素或多西环素治疗.     

小儿难治性肺炎支原体肺炎临床特征及免疫机制研究

目的 探讨难治性支原体肺炎(RMPP)小儿临床特征及免疫机制.方法 以2017年3月至2019年3月本院收治的RM PP患儿92例为观察组,按病情轻重再分为RM PP重度组和RM PP轻度组.同期按1:2收集46例普通肺炎患儿为对照组.应用流式细胞仪检测肺泡灌洗液中T细胞亚群水平,采用酶联免疫吸附试验检测白细胞介素-5...     

痰热清注射液辅助治疗呼吸机相关性肺炎的Meta分析

目的 观察痰热清注射液对呼吸机相关性肺炎(VAP)患者的临床疗效及预后情况的影响.方法 检索PubMed、Embase、Cochrane、中国知网、万方、维普、中国生物医学文献数据库,纳入痰热清注射液治疗VAP的随机对照试验,以总有效率、抗生素使用时间、重症监护病房(ICU)住院时间、机械通气时间、脱机成功率、死亡率为...     

沐舒坦压缩雾化吸入辅助治疗婴儿肺炎96例疗效观察

目的 观察沐舒坦辅助治疗婴儿肺炎的临床疗效。方法 96例婴儿肺炎随机分为两组,治疗组（n=52）在对照组（n=44）综合治疗的基础上加用沐舒坦压缩雾化吸入治疗。结果 治疗组在临床症状、体征消失时间,缩短病程等方面均较对照组缩短（χ^2=5．24,p〈0．05）,差异有显著性。结论 沐舒坦压缩雾化吸入辅助治疗婴儿肺炎疗效显著。     

PICU患儿发生呼吸机相关性肺炎的影响因素

目的 探讨儿童重症监护病房(pediatric intensive care unit,PICU)患儿发生呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的影响因素,并构建预测模型.方法 回顾性分析2015年1月～2019年6月本院PICU收治的600例行机械通气治疗的患儿,统...     

102例胸外科手术患者肺炎克雷伯菌血流感染的临床特征及其对抗菌药物的敏感性分析

目的:分析医院胸外科手术患者肺炎克雷伯菌血流感染的临床特征及其药敏试验结果,为胸外科术后肺炎克雷伯菌血流感染患者抗菌药物的合理使用提供参考.方法:抽取2015年1月-2018年1月间胸外科收治的手术治疗后并发肺炎克雷伯菌血流感染患者102例资料,分析其肺炎克雷伯菌血流感染的临床特征及其对抗菌药物药敏试验结果.结果:10...     

葛根汤颗粒治疗上呼吸道感染所致小鼠病毒性肺炎及死亡保护作用

目的：研究葛根汤颗粒对甲型H₁N₁流感病毒PR8株感染致小鼠病毒性肺炎模型的治疗及死亡保护作用。方法：采用甲型H₁N₁流感病毒(PR8株)滴鼻感染小鼠造成病毒性肺炎模型,观察小鼠的肺指数和肺指数抑制率,肺内细支气管及肺组织苏木精-伊红(HE)染色病理切片镜下病变观察及等级评分;同时采用流感病毒PR8毒株滴鼻感染小鼠造成死亡保护模型,观察小鼠感染后2周内的死亡情况,计算小鼠的死亡率、死亡保护率、平均存活天数和生命延长率。结果：葛根汤颗粒高、中剂量组可显著降低模型组小鼠肺指数(P<0.01);葛根汤颗粒高、中剂量组与模型组比较可显著减轻支气管炎症反应渗出状况,红肿相对消退,并且缓解病毒感染所致肺泡、肺间质渗出炎症反应及红细胞渗出情况(P<0.01,P<0.05);模型组小鼠死亡率90%,平均存活天数9.95 d,葛根汤颗粒3个剂量组与模型组比较可显著降低小鼠死亡率,延长小鼠平均存活天数,提高生命延长率(P<0.01,P<0.05)。结论：本研究发现葛根汤颗粒可显著降低病毒性...     

Streptococcus pneumoniae Serotypes Associated with Death,South Africa, 2012–2018

The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. The most common serotypes causing IPD were 8 and 19A. In patients <15 years of age, serotypes associated with increased CFR in IPD, compared with serotype 8 and controlling for confounding factors, were 11A, 13, 19F, 15A, and 6A. None of these serotypes were associated with increased CFR in meningitis. Among IPD patients >15 years of age, serotype 15B/C was associated with increased CFR. Among meningitis patients of all ages, serotype 1 was associated with increased CFR. PCV13 serotypes 1, 3, 6A, 19A, and 19F should be monitored, and serotypes 8, 12F, 15A, and 15B/C should be considered for inclusion in vaccines to reduce deaths caused by S. pneumoniae.