摘要
目的探讨老年人群重症肺炎的临床特点并对其预测指标进行分析。方法回顾性分析2018年7月—2020年7月在泰州市人民医院就诊的457例老年肺炎患者的临床资料,分为重症肺炎组(n=52)和非重症肺炎组(n=405)。收集患者的临床基本资料和实验室检查结果。通过多因素Logistic回归明确影响老年肺炎患者发展为重症的危险因素。结果同非重症肺炎组相比,重症肺炎组年龄更大、合并糖尿病比例更高、PaO_(2)/FiO_(2)和淋巴细胞比例更低,而APACHEⅡ评分、降钙素原水平、C反应蛋白水平和凝血酶原时间更高(P均<0.05)。重症肺炎组病毒感染、细菌感染、病毒合并细菌感染和真菌感染分别有22例(42.3%)、17例(32.7%)、10例(19.2%)和3例(5.8%)。年龄>70岁、糖尿病、淋巴细胞比例降低、PaO_(2)/FiO_(2)<250mmHg、降钙素原水平升高、APACHEⅡ分值增加以及凝血酶原时间延长是老年肺炎患者进展为重症肺炎的独立危险因素。结论老年患者发生重症肺炎的风险较高。年龄增加、糖尿病、淋巴细胞比例降低、PaO_(2)/FiO_(2)<250mmHg、降钙素原水平升高以及APACHEⅡ分值增加和凝血酶原时间延长可能是早期识别重症肺炎的主要预测指标。
Objective To investigate the clinical characteristics of severe pneumonia in the elderly and analyze its predictive indicators.Methods The clinical data of 457 elderly patients with pneumonia treated in People’s Hospital of Taizhou City from July 2018 to July 2020 were retrospectively analyzed.They were divided into severe pneumonia group(n=52)and non-severe pneumonia group(n=405).The basic clinical data and laboratory test results of the patients were collected.Multivariate Logistic regression was used to identify the risk factors for the development of severe pneumonia in elderly patients with pneumonia.Results Compared with the non-severe pneumonia group,the severe pneumonia group was older,and had a higher proportion of diabetes mellitus,lower PaO_(2)/FiO_(2)and lymphocyte ratios,while the APACHEⅡscore,procalcitonin level,C-reactive protein level were higher and prothrombin time was longer(all P<0.05).In severe pneumonia group,there were22cases(42.3%),17ones(32.7%),10ones(19.2%)and3ones(5.8%)of virus infection,bacterial infection,virus combined with bacterial infection and fungal infection,respectively.Age>70 years old,diabetes,decreased lymphocyte ratio,PaO_(2)/FiO_(2)<250mmHg,increased procalcitonin level,increased APACHEⅡscore and prolonged prothrombin time were independent risk factors for the progression of severe pneumonia in elderly patients with pneumonia.Conclusion Elderly patients have a higher risk of severe pneumonia.Increased age,diabetes,decreased lymphocyte ratio,PaO_(2)/FiO_(2)<250mmHg,increased procalcitonin level,increased APACHEⅡscore and prolonged prothrombin time may be the main predictors for early identification of severe pneumonia.
作者
李雨凤
章淑君
Li Yufeng;Zhang Shujun(Department of Emergency,People’s Hospital of Taizhoun City,Taizhou,Jiangsu,225300,P.R.China;Department of Respiratory and Critical Care Medicine,Fifth People’s Hospital of Wuxi City,Wuxi,Jiangsu,214000,P.R.China)
出处
《老年医学与保健》
CAS
2022年第3期589-593,共5页
Geriatrics & Health Care
关键词
老年
重症肺炎
早期干预
预测因子
elderly
severe pneumonia
early intervention
predictor
