pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2010-4-58-65pulmo-1672Research ArticleСтатьиНозокомиальная пневмония у больных хронической обструктивной болезнью легкихАвдеевС. Н.serg_avdeev@list.ruБаймакановаГ. Е.gulsara.bai@mail.ruЗубаироваП. А.zubairova @mail.ruЧучалинА. Г.noemail@neicon.ruФГУ "НИИ пульмонологии" ФМБА России: 105077Russian Federation201028082010045865Copyright © Авдеев С.Н., Баймаканова Г.Е., Зубаирова П.А., Чучалин А.Г., 20102010Авдеев С.Н., Баймаканова Г.Е., Зубаирова П.А., Чучалин А.Г.Авдеев С.Н., Баймаканова Г.Е., Зубаирова П.А., Чучалин А.Г.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1672

Нозокомиальная пневмония (НП) - одно из наиболее часто встречающихся в стационаре инфекционных заболеваний. Одним из фак- торов риска развития НП является хроническая обструктивная болезнь легких (ХОБЛ). Целью исследования стало изучение особеннос- тей НП и роли биомаркеров воспаления у больных ХОБЛ. Были обследованы 184 пациента с обострением ХОБЛ. У 22 (11,9 %) больных пневмония развилась в условиях стационара. Среди них - 18 мужчин и 4 женщины; средний возраст составил 66,0 ± 11,02 года. Значе- ние шкалы CPIS для всех больных ХОБЛ с НП составило 9,4 ± 2,1 балла, индекс коморбидности Charlson - 7,9 ± 2,5 балла. У 90,9 % больных НП развилась после 5 дней пребывания в стационаре. У больных были выделены следующие микроорганизмы: Pseudomonas aeruginosa (5), Staphylococcus aureus (4), Streptococcus pneumoniae (4), Acinetobacter spp. (3). Проведение инвазивной вентиляции легких потре- бовалось 13,6 %, неинвазивной вентиляции легких - 36,4 %, оксигенотерапии - 90,9 % больных. Средняя продолжительность госпита- лизации больных ХОБЛ с НП составила 42,6 ± 20,3 дней, умерли 27,3 % пациентов. Концентрации сывороточного С-реактивного бел- ка (СРБ) в день развития НП значительно превышали их исходные значения: 105,5 (83,3-145,8) мг / л vs 14,5 (12,0- 29,3) мг / л (p < 0,0001). Динамика СРБ позволяла предсказать прогноз больных НП (p = 0,002). Таким образом, НП у больных ХОБЛ характеризуется тяжелым течением, выраженной системной воспалительной реакцией и острой дыхательной недостаточностью. Наряду со шкалой АРАСНЕ II биомаркеры воспаления позволяют определить прогноз и исходы НП.

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The authors declare that there are no conflicts of interest present.