【摘要】 目的 〖JP2〗研究質(zhì)子泵抑制劑（PPI）是否為危重患者發(fā)生醫(yī)院獲得性肺炎的危險因素。 方法 收集2002年6月-2009年6月收治的198例重癥患者資料，分為使用PPI組（96例）和未使用PPI組（102例）。采用logistic回歸分析PPI使用情況和醫(yī)院獲得性肺炎的關(guān)系。 結(jié)果 使用PPI組肺炎的發(fā)生率較高（26.9%），尤其是PPI使用時間超過7 d者（37.5%）。在不同的多變量logistic回歸模型中，分別用APACHE Ⅱ評分和入住重癥監(jiān)護室原因校正后，使用PPI以及使用天數(shù)均是醫(yī)院獲得性肺炎發(fā)生的危險因素（P=0.031，OR＝2.230，95%CI：1.957~2.947；P=0.002，OR＝1.824，95%CI：1.457~2.242）。 結(jié)論 長時間應(yīng)用PPI可能是增加ICU患者發(fā)生醫(yī)院獲得性肺炎的一種風(fēng)險因素。
【Abstract】 Objective To identify whether proton pump inhibitors (PPI) is a risk factor of hospital-acquired pneumonia (HAP) in critical patients. Methods The clinical data of the critical patients admitted to ICU from June 2002 to June 2009 were retrospectively analyzed. A total of 198 patients were divided into two groups: 96 in PPI group and 102 in non-PPI group. The relationship between PPI and HAP was analyzed by logistic regression. Results The patients in PPI group had a higher risk of HAP (26.9%), especially who were treated with PPI more than 7 days (37.5%). Adjusted by APACHE Ⅱ score and reason for admission to ICU, PPI therapy and the using duration of PPI were both the risk factors of HAP in different multiple logistic models (P=0.031, OR=2.230, 95%CI: 1.957-2.947; P=0.002, OR=1.824, 95%CI: 1.457-2.242). Conclusion Long-term use of PPI is a risk factor of HAP.
引用本文： 王曉虹,王瑜,胡良安. 質(zhì)子泵抑制劑和重癥患者的醫(yī)院獲得性肺炎之間的關(guān)系. 華西醫(yī)學(xué), 2010, 25(10): 1811-1812. doi: 復(fù)制
| 1. | Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system[J]. Crit Care Med, 1985, 13(10): 818-829. |
| 2. | 陳灝珠. 實用內(nèi)科學(xué)[M]. 11版. 北京: 人民衛(wèi)生出版社, 2003:. |
| 3. | Herzig SJ, Howell MD, Ngo LH, et al. Acid-suppressive medication use and the risk for hospital-acquired pneumonia[J]. JAMA, 2009, 301(20): 2120-2128. |
| 4. | Gulmez SE, Holm A, Frederiksen H, et al. Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study[J]. Arch Intern Med, 2007, 167(9): 950-955. |
| 5. | Leroy O, Soubrier S. Hospital-acquired pneumonia: risk factors, clinical features, management, and antibiotic resistance[J]. Curr Opin Pulm Med, 2004, 10(3): 171-175. |
- 1. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system[J]. Crit Care Med, 1985, 13(10): 818-829.
- 2. 陳灝珠. 實用內(nèi)科學(xué)[M]. 11版. 北京: 人民衛(wèi)生出版社, 2003:.
- 3. Herzig SJ, Howell MD, Ngo LH, et al. Acid-suppressive medication use and the risk for hospital-acquired pneumonia[J]. JAMA, 2009, 301(20): 2120-2128.
- 4. Gulmez SE, Holm A, Frederiksen H, et al. Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study[J]. Arch Intern Med, 2007, 167(9): 950-955.
- 5. Leroy O, Soubrier S. Hospital-acquired pneumonia: risk factors, clinical features, management, and antibiotic resistance[J]. Curr Opin Pulm Med, 2004, 10(3): 171-175.