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目的探讨继发性免疫抑制患者（ＩＣＨ）肺部感染的病原体分布及影响预后的相关因素。方法对１９８６年１２月～１９９６年１２月期间经病原学和（或）病理学确诊的ＩＣＨ并发肺部感染８０例进行回顾性分析。结果病原体（除巨细胞病毒）分布：普通细菌４５例（５６％），结核杆菌２３例（２９％），真菌９例（１１％），卡氏肺囊虫３例（４％）。ＩＣＨ并发肺部感染的病死率，年龄＜６０岁为４８％，≥６０岁为６７％，并发菌血症的病死率为８６％，无菌血症的病死率为４５％，白细胞计数＞１０×１０９／Ｌ和＜４０×１０９／Ｌ的病死率分别为６７％，８７％，（４０～１０）×１０９／Ｌ病死率为２３％，弥漫性病灶和局限性病灶病死率分别为６５％和２３％（Ｐ＜０．０５，Ｐ＜０．０１）。ＩＣＨ并发肺部感染的病死率在年龄、有无菌血症、白细胞计数高低、病灶累及范围方面差异有显著性。病死率在性别、基础疾病、病原体种类、混合感染方面差异无显著性（Ｐ＞０．０５）。结论细菌是ＩＣＨ肺部感染最常见的病原体之一，在我国ＩＣＨ肺结核的激活和复燃应引起足够重视。
Objective To investigate the distribution of pathogens in pulmonary infection of secondary immunosuppressive patients (ICH) and the related factors that affect prognosis. Methods A retrospective analysis of 80 patients with ICH complicated with pulmonary infection confirmed by pathogenic and / or pathology from December 1986 to December 1996 was performed. Results The distribution of pathogens (except cytomegalovirus) was 45 cases (56%) of common bacteria, 23 cases (29%) of Mycobacterium tuberculosis, 9 cases (11%) of fungi and 3 cases (4%) of Pneumocystis carinii. The mortality of patients with ICH complicating pulmonary infection was 48% at age 60 years, 67% at 60 years of age, 86% with concurrent bacteremia, 45% with bacteremia, and a white blood cell count> 10 The case fatality rates were 67%, 87%, and (40 ~ 10) × 109 / L, respectively. The case fatality rate was 23% Respectively, 65% and 23% (P <0.05, P <0.01). ICH complicated with pulmonary infection mortality in age, with no bacteremia, white blood cell count, the range of lesions involved significant differences. There was no significant difference in case fatality rate between gender, underlying disease, pathogen type and mixed infection (P> 0.05). Conclusion Bacteria are one of the most common pathogens of pulmonary infection in ICH. The activation and reactivation of ICH in our country should be paid enough attention.