摘要
目的探讨急诊收治的老年吸入性肺炎患者的营养状况、感染严重程度等对短期预后的影响,进行危险因素的评价。方法回顾性分析2015年1月至2018年3月北京同仁医院急诊科收治的老年吸入性肺炎患者116例,评估入院时患者营养评分、PSI(pneumonia severity index)评分及BMI(body mass index)值,收集白细胞总数(WBC)、中性粒细胞比例,高敏C反应蛋白、降钙素原(PCT)、淋巴细胞总数、血清白蛋白、血红蛋白、总胆固醇、甘油三脂、胆碱酯酶(ChE)等各项临床指标,所有患者以入院第30天为节点,根据预后分为治愈及好转组和死亡组。结果BMI、白蛋白、胆碱酯酶、血红蛋白值在死亡组明显低于治愈及好转组,两组间差异有统计学意义(P<0.05)。PSI评分、营养评分、白细胞总数、高敏C反应蛋白、降钙素原在死亡组明显高于治愈及好转组,两组间差异有统计学意义(P<0.05)。对在单因素分析中有统计学意义的指标继续应用Logistic回归进行分析,白细胞总数、胆碱酯酶、PSI评分、营养评分四个指标在多因素分析中具有统计学意义。影响程度由高到低依次为营养评分(1.945),WBC(1.152),PSI(1.032),胆碱酯酶(0.999)。结论老年吸入性肺炎患者的营养状况、炎症感染的严重程度等因素对患者预后有显著影响,因此在患者入院时应纠正贫血、营养不良,积极控制感染,重点要关注患者营养评分、PSI评分、白细胞总数及胆碱酯酶水平,均为影响患者预后的关键因素。
Objective To explore the effects of nutritional status and severity of infection on short-term prognosis in elderly patients with aspiration pneumonia (AP), and to evaluate the risk factors of the disease. Methods Total of 116 elderly AP patients were retrospectively analyzed who were treated in emergency of Beijing Tongren Hospital between January 2015 and March 2018. Nutrition index, PSI and BMI of the patients were assessed on admission, while white blood cell count(WBC), neutrophil ratio, high sensitivity C-reactive protein (CRP), procalcitonin(PCT), total lymphocyte count, serum albumin, hemoglobin, cholesterol , triglycerides and cholinesterase were assessed during hospitalization. All 116 patients were divided into survival group or death group after admission 30 days. Results Totally 116 elderly AP patients treated in Emergency Department of Beijing Tongren Hospital between January 2015 and March 2018 were retrospectively analyzed. Nutrition index, PSI and body mass index (BMI) of the patients were assessed on admission, while white blood cell count (WBC), neutrophil ratio, high sensitivity C-reactive protein (CRP), procalcitonin (PCT), total lymphocyte count, serum albumin, hemoglobin, cholesterol, triglycerides and cholinesterase were assessed during hospitalization. All 116 patients were divided into the survival group or the death group according to the prognosis on 30 days after admission. Conclusions Nutrition status and the severity of infection have significant impact on the prognosis of elderly patients with AP, and for indicators, nutrition index, WBC, PSI and cholinesterase levels were crucial. The effective anemia amelioration, nutrition improvement and infection control are essential components for reducing mortality of elderly patients with AP.
作者
田玮
丁宁
ian Wei;Ding Ning(Department of Emergency Medicine,Tongren Hospital of Capital Medicine Univercity,Beijing 100730,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2019年第6期743-747,共5页
Chinese Journal of Emergency Medicine
关键词
老年人
吸入性肺炎
预后
营养
危险因素
Aged
Aspiration pneumonia
Prognosis
Nutrition
Risk factors
