【摘要】 目的:比较分析阿坝地区儿童社区获得性肺炎(CAP)与医院获得性肺炎(HAP)的临床特征及菌株分布,为临床治疗提供理论参考。方法:回顾性分析我院2016年1月至2018年6月收治的142例CAP患儿和同期因其他非呼吸系统疾病住院的46例HAP患儿的临床特征、住院时间、入院体征及C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)等相关实验室指标及病原菌的分布情况。结果:在入院或临床确诊时的肺炎相关体征方面,CAP组(69.0%)患儿相关体征多于HAP组(47.8%);CAP组肺炎治愈所需时间短于HAP组(t=2.53,P <0.05);实验室监测指标中除WBC外(t=1.97,P<0.05),其余相关指标比较差异均无统计学意义。CAP组患儿主要检出病原菌为肺炎克雷伯菌(18.25%)、大肠埃希菌(15.08%)、肺炎链球菌(13.49%)和铜绿假单胞菌(11.11%); HAP组患儿检出鲍曼不动杆菌的比例相对较高(17.65%)。CRP动态监测中,CAP组患儿CRP降低更为明显,治疗第7天HAP组患儿CRP水平高于CAP组(t=2.65,P<0.05)。结论:儿童感染CAP与HAP发病特点有所不同,尤其是HAP诊断及治疗相对困难,应予以重点关注。更多还原

【Abstract】 Objective: To compare and analyze the clinical characteristics and strain distribution of community-acquired pneumonia( CAP) and hospital-acquired pneumonia( HAP) in children in Aba area,so as to provide theoretical reference for clinical treatment.Methods: Retrospective analysis was conducted on clinical data of 142 cases of children with CAP and 46 cases of children with HAP induced by other non-respiratory diseases in our hospital from Jan. 2016 to Jun. 2018,including clinical characteristics,length of stay,signs of admission,C-reactive protein( CRP),procalcitonin( PCT),white blood cell count( WBC) and other related laboratory indicators and the distribution of pathogens. Results: In terms of pneumonia-related signs at admission or clinical diagnosis,the CAP group( 69. 0%) showed more signs than the HAP group( 47. 8%). The cure time of pneumonia in the CAP group was shorter than that in the HAP group( t = 2. 53,P<0. 05). Except for WBC( t = 1. 97,P<0. 05),there was no statistically significant difference in other related indicators. The main pathogens detected in the CAP group were Klebsiella pneumonia( 18. 25%),Escherichia coli( 15. 08%),Streptococcus pneumoniae( 13. 49%) and Pseudomonas aeruginosa( 11. 11%). The proportion of Acinetobacter baumannii in children in the HAP group was relatively high( 17. 65%). In the dynamic monitoring of CRP,the decrease in children in the CAP group was more significant,and the CRP level in the HAP group was higher than that in the CAP group on the 7 thday of treatment( t = 2. 65,P<0. 05).Conclusion: The characteristics of children infected with CAP and HAP are different,especially the diagnosis and treatment of HAP are difficult,which should be paid more attention to.更多还原