成人社区获得性肺炎主要病原体分布的Meta分析

发布时间：2018-08-19 14:43

【摘要】：目的综合分析并评价成人社区获得性肺炎(community acquired pneumonia,CAP)主要病原体的分布情况,以期为临床初始用药提供理论支持。方法对病原体的检出率进行Meta分析,根据异质性检验结果对其检出率加权合并,以明确不同病原体的分布情况。结果 (1)病原体的检出率为47.00%(95%CI:40.90%~53.20%),其中病毒、肺炎链球菌、非典型病原体和混合病原体检出率分别为23.10%(95%CI:14.10%~35.30%)、14.90%(95%CI:9.60%~22.40%)、9.40%(95%CI:6.10%~14.40%)和8.40%(95%CI:5.80%~11.90%);(2)非中国人群病毒检出率最高,中国人群非典型病原体的检出率最高,肺炎链球菌检出率低于非中国人群(P=0.035);(3)60岁及以上人群检出率最高的是病毒,其次为非典型病原体;(4)心脑血管疾病为CAP患者最可能合并的疾病。结论近半数患者未检出病原体,病毒、肺炎链球菌、非典型病原体为成人CAP检出率较高的病原体,混合病原体感染不可忽视,中国人群与非中国人群病原体分布有所差异。
[Abstract]:Objective to analyze and evaluate the distribution of major pathogens of adult community-acquired pneumonia (community acquired) pneumoniae CAP in order to provide theoretical support for the initial use of drugs. Methods the detection rate of pathogens was analyzed by Meta and weighted combination according to the results of heterogeneity test to determine the distribution of different pathogens. Results (1) the detection rate of pathogens was 47.00% (95 CI: 40.900.9053.20%), in which the detection rates of viruses, Streptococcus pneumoniae, atypical pathogens and mixed pathogens were 23.10% (95CI: 14.1010 35.30%), 14.90% (95CIW 9.6022.40%), 9.40% (95CI: 6.100.14.40%) and 8.40% (95CI: 5.80m 11.90%); (2) respectively. The detection rate of atypical pathogens in Chinese population was the highest. The detection rate of Streptococcus pneumoniae was lower than that of non-Chinese population (P0. 035); (3). The highest detection rate of Streptococcus pneumoniae was virus, followed by atypical pathogen, and (4) Cardiovascular and cerebrovascular diseases were the most likely to be associated with CAP. Conclusion nearly half of the patients did not detect pathogens, such as virus, Streptococcus pneumoniae and atypical pathogens, which are the pathogens with high detection rate of CAP in adults. The mixed pathogens infection should not be ignored, and the distribution of pathogens in Chinese and non-Chinese populations is different.
【作者单位】：怀化市第一人民医院临床药学研究室;中南大学药学院;怀化市洪江区疾病控制中心;中南大学临床药理研究所;
【基金】：湖南省医药卫生科研项目计划(No.B2015-181) 湖南省教育厅科研项目计划(No.14C0915) 2015年怀化市科技局项目计划(No.2015F3104)
【分类号】：R563.1

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