中文摘要：

目的：探讨急性脑血管疾病肺部感染的病原菌分布、危险因素及耐药性，以期提高临床治疗水平。方法随机选取2011年6月-2013年5月2765例急性脑血管疾病患者为研究对象，回顾性分析合并肺部感染患者病原菌分布、危险因素及耐药性。结果2765例急性脑血管疾病患者中发生肺部感染226例，感染率为8．17％；感染部位以呼吸道和泌尿道为主；共分离出病原菌248株，其中革兰阳性218株占87．90％，革兰阳性菌26株占10．48％，真菌4株，占1．62％；革兰阴性菌对常用抗菌药物耐药率普遍较高，但对亚胺培南、头孢哌酮/舒巴坦、头孢吡肟、阿米卡星仍保持敏感，耐药率＜15．0％；年龄、侵入性操作、住院时间长、病情严重、营养不良是急性脑血管疾病肺部感染危险因素（ P＜0．05）；治愈率为88．94％。结论急性脑血管疾病患者肺部感染发病率较高，对危险因素进行综合管理，重点监控，明确病原菌，根据药敏结果合理用药，可有效降低肺部感染发生率。

英文摘要：

OBJECTIVE To explore the distribution and drug resistance of pathogens causing pulmonary infections in cerebrovascular disease patients and analyze the risk factors so as to improve the level of clinical treatment . METHODS From Jun 2011 to May 2013 ,a total of 2 765 cerebrovascular disease patients were randomly recruited as the study objects ,then the distribution and drug resistance of the pathogens causing pulmonary infections as well as the risk factors were retrospectively analyzed .RESULTS Of the 2 765 cerebrovascular disease patients ,the pulmonary infections occurred in 226 cases with the infection rate of 8 .17% ;the respiratory tract and urinary tract were the predominant infection sites .Totally 248 strains of pathogens have been isolated ,including 218 （87 .90% ） strains of gram-positive bacteria ,26 （10 .48% ） strains of gram-positive bacteria ,and 4 （1 .62% ） strains of fungi . The gram-negative bacteria were highly resistant to the commonly used antibiotics but maintained susceptible to imipenem ,cefoperazone-sulbactam ,cefepime ,and amikacin ,with the drug resistance rate less than 15 .0% .The age ,invasive operation ,long hospitalization duration ,serious condition ,and malnutrition were the risk factors for pulmonary infections in the cerebrovascular disease patients （P〈0 .05）;the cure rate was 88 .94% .CONCLUSION The incidence of pulmonary infections is high among the cerebrovascular disease patients .It is an effective way to conduct comprehensive management of the risk factors ,focus on monitoring ,define the pathogens ,and reasonably use antibiotics according to the results of drug susceptibility testing so as to reduce the incidence of pulmonary in-fections .