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目的:验证呼吸机相关性肺炎(VAP)患者伴血流感染与应激性高血糖的关联性。方法:应用医院感染监测方法追踪贵州医科大学第三附属医院机械通气VAP患者发生伴血流感染情况。研究队列为2016年1月至2020年1月入住重症监护病房(ICU)所有接受有机械通气治疗并发生VAP患者。采用回顾性巢式病例对照研究设计，用多因素n logistic回归分析比较应激性高血糖与血糖正常VAP组间伴血流感染发生的差异。n 结果:共有113例血流感染VAP及452例非血流感染VAP患者进入研究。2组间患者总住院时间与入住ICU时间的差异均有统计学意义(均n P<0.01)。相对于血糖正常VAP患者，应激性高血糖VAP患者发生伴血流感染风险较大(n OR＝2.974，95%n CI 1.735～5.100, n P<0.01)。VAP患者中，相对于非血流感染患者，血流感染患者抗菌药物使用时间增加(n P<0.01)。n 结论:ICU机械通气患者中应激性高血糖VAP显著增加伴血流感染发生风险，增加治疗难度，延长住院治疗时间。“,”Objective:To verify the relationship between ventilator-associated pneumonia (VAP) patients with their bloodstream infection and stress hyperglycemia.Methods:The nosocomial infection monitoring method was used to investigate the incidence of bloodstream infection in VAP patients with mechanical ventilation in the Third Affiliated Hospital of Guizhou Medical University. From January 2016 to January 2020, all patients who received mechanical ventilation treatment and had VAP in intensive care unit (ICU) were enrolled. A retrospective nested case-control study design was used to compare the differences of blood flow infection between stress hyperglycemia and normal blood glucose VAP.Results:One hundred and thirteen VAP patients with bloodstream infection and 452 VAP patients without bloodstream infection entered the study. The differences of total length of stay and ICU stay time between the two groups were statistically significant (both n P<0.01). Compared with patients with normal blood glucose VAP, patients with stress hyperglycemia VAP had a higher risk of blood flow infection (n OR=2.974, 95%n CI 1.735-5.100, n P<0.01). In VAP patients, compared with patients without bloodstream infection, patients with bloodstream infection would have longer antibacterial use time (n P<0.01).n Conclusion:Stress hyperglycemia VAP in ICU patients with mechanical ventilation significantly increased the risk of blood flow infection, increased the difficulty of treatment, prolonged hospitalization stay.