摘要
目的探究与分析老年社区获得性肺炎(community-acquired pneumonia,CAP)营养状况与严重程度的相关性,及其对预后的影响。方法回顾性分析作者医院自2019-04/2022-02月收治的221例老年CAP患者临床资料。采用肺炎严重指数(pneumonia severity index,PSI)量表将患者分为高危肺炎组(n=48)和非高危肺炎组(n=173)。在两组患者入院后的72 h内采用营养风险筛查2002(nutritional risk screening 2002,NRS-2002)量表对患者的营养情况进行调查,同时对比两组患者的背景资料、实验室资料;首先采用单因素分析对比上述指标,对存在明显差异性的因素采用多因素Logistic回归分析进行评价。根据其营养状况分为营养正常组(n=93)与营养风险组(n=128),对比两组患者预后。结果与非高危肺炎组相比,高危肺炎组年龄较高、PSI-Ⅰ较高,NRS-2002量表评分较高,差异有统计学意义(P均<0.05)。高危肺炎组与非高危肺炎组相比白细胞计数(white blood cell,WBC)、中性粒细胞百分比(neutrophil granulocyte percentage,NEUT%)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、D-二聚体(D-dimer,D-D)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatine,Scr)、脑钠肽(brain natriuretic peptide,BNP)、心肌肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)、白细胞介素6(interleukin 6,IL-6)较高,血小板计数(platelet,PLT)、白蛋白(albumin,ALB)、CD4~+T细胞计数、CD8~+T细胞计数较低,差异有统计学意义(P均<0.05)。Logistic回归分析显示,WBC、NEUT%、CRP、PCT、D-D、ALT、BUN、Scr、BNP、cTnⅠ水平及NRS-2002量表评分升高,PLT、ALB、CD4~+T细胞计数、CD8~+T细胞计数降低被认为是影响老年CAP发生高危肺炎的危险因素(P<0.05)。营养风险组与营养正常组相比患者呼吸机使用率较高、住院死亡率较高、14天内再住院率较高,差异有统计学意义(P均<0.05)。结论在老年CAP�
Objective To explore and analyze the correlation between the severity of community-acquired pneumonia(CAP)and nutritional status in the elderly and its impact on prognosis.Methods The clinical data of 221 elderly patients with CAP admitted to author′s hospital from April 2019 to February 2022 were retrospectively analyzed.The severity of CAP in this group was determined by pneumonia severity index(PSI)scale.The patients were divided into high-risk pneumonia group(n=48)and non-high-risk pneumonia group(n=173).The nutritional status of patients in both groups within 72 hours after admission was investigated by nutritional risk screening 2002(NRS-2002)scale,at the same time,the background data and laboratory data of the two groups of patients were compared;first,the above indicators were compared by univariate analysis,and the factors with significant differences were evaluated by multivariate Logistic regression analysis.According to their nutritional status,they were divided into nutritionally normal group(n=93)and the nutritional risk group(n=128),and the prognosis of the two groups was compared.Results Compared with the non-high-risk pneumonia group,the high-risk pneumonia group had higher age,higher PSI-Ⅰand higher NRS-2002 scale score,and the difference was statistically significant(all P<0.05).Compared with the non-high-risk pneumonia group,the high-risk pneumonia group had higher white blood cell(WBC),neutrophil granulocyte percentage(NEUT%),C-reactive protein(CRP),procalcitonin(PCT),D-dimer(D-D),alanine aminotransferase(ALT),blood urea nitrogen(BUN),serum creatine(Scr),brain natriuretic peptide(BNP),cardiac troponinⅠ(cTnⅠ)and Interleukin-6(IL-6),lower platelet(PLT),albumin(ALB),CD4T cells counts and CD8T cells counts,and the difference was statistically significant(all P<0.05).Logistic regression analysis showed that the scores of WBC,NEUT%,CRP,PCT,D-D,ALT,BUN,Scr,BNP,cTnⅠ,and NRS-2002 scale increased,and the decrease of PLT,ALB,CD4T cells counts and CD8T cells counts were considered to be high-ri
作者
李驹波
赵红亮
李俊丽
牛东升
LI Jubo;ZHAO Hongliang;LI Junli;NIU Dongsheng(Department of Emergency,Jincheng People's Hospital,Jincheng Shanri 048000,China)
出处
《华南国防医学杂志》
CAS
2022年第10期785-788,共4页
Military Medical Journal of South China
基金
晋城市重点科技研发项目(20210101)。
关键词
老年社区获得性肺炎
严重程度
营养状况
相关性
Community-acquired pneumonia in the elderly
Severity
Nutritional status
Correlation
