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目的研究质子泵抑制剂(PPI)是否为危重患者发生医院获得性肺炎的危险因素。方法收集2002年6月-2009年6月收治的198例重症患者资料,分为使用PPI组(96例)和未使用PPI组(102例)。采用logistic回归分析PPI使用情况和医院获得性肺炎的关系。结果使用PPI组肺炎的发生率较高(26.9%),尤其是PPI使用时间超过7d者(37.5%)。在不同的多变量logistic回归模型中,分别用APACHEⅡ评分和入住重症监护室原因校正后,使用PPI以及使用天数均是医院获得性肺炎发生的危险因素(P=0.031,OR=2.230,95%CI:1.957～2.947;P=0.002,OR=1.824,95%CI:1.457～2.242)。结论长时间应用PPI可能是增加ICU患者发生医院获得性肺炎的一种风险因素。
Objective To study whether proton pump inhibitor (PPI) is a risk factor for nosocomial pneumonia in critically ill patients. Methods The data of 198 severe cases admitted from June 2002 to June 2009 were collected and divided into PPI group (96 cases) and non-PPI group (102 cases). Logistic regression analysis was used to analyze the relationship between PPI use and hospital-acquired pneumonia. Results The incidence of pneumonia in the PPI group was higher (26.9%), especially in PPI patients over 7 days (37.5%). In different multivariate logistic regression models, PPACH and days of hospital admission were the risk factors for hospital-acquired pneumonia with APACHE II score and admission to intensive care unit (P = 0.031, OR = 2.230, 95% CI : 1.957-2.977; P = 0.002, OR = 1.824, 95% CI: 1.457-2.242). Conclusion Long-term application of PPI may be a risk factor for increasing hospital-acquired pneumonia in ICU patients.