摘要
目的探讨早期血清磷水平变化对老年社区获得性肺炎病情及预后的影响。方法选取齐河县疾病预防控制中心检验科2020年5月~2022年5月纳入的103例社区获得性肺炎老年患者,根据病情严重程度分为重症组(n=25)和轻症组(n=78)。对比两组患者的血清磷、血气分析、血常规等指标的水平,采用Logistic回归分析老年社区获得性肺炎的独立危险因素,采用Spearman相关性分析检验病情严重程度与低磷血症、氧合指数的相关性。结果重症组的CRP、氧合指数、血清钾、血清磷及低磷血症的发生率与轻症组对比差异有统计学意义(P<0.05),两组患者性别、年龄、体重指数、合并疾病、淋巴细胞计数、谷氨酸氨基转移酶、肌酐、脑利钠肽、白介素-6、血清钙、血清氯、血清钠对比差异无统计学意义(P>0.05);Logistic回归分析显示,血清磷及低磷血症均为老年社区获得性肺炎的独立危险因素(P<0.05);Spearman相关性分析显示,病情严重程度与低磷血症呈正相关(r=0.520,P<0.05),氧合指数与低磷血症呈负相关(r=-0.385,P=0.001),病情严重程度与氧合指数呈负相关(r=-0.695,P<0.05)。低磷血症组的机械通气病例数、ICU住院病例数、重症病例数及住院期间死亡病例数明显多于非低磷血症组患者(P<0.05)。结论老年社区获得性肺炎患者表现为低血磷水平,其和预后与低磷血症存在着密切的关系。
Objective To investigate the effect of early serum phosphorus level changes on the disease severity and prognosis of community-acquired pneumonia(CAP)in elderly patients.Methods A total of 103 elderly patients with CAP enrolled in Qihe County Center for disease control and prevention laboratory from May 2020 to May 2022 were selected and divided into severe group(n=25)and mild group(n=78)according to the disease severity.The serum phosphorus,arterial blood gas analysis,blood routine analysis and other indicators were compared between the two groups.The independent risk factors of CAP in the elderly were analyzed by Logistic regression,and Spearman correlation analysis was performed to examine the correlation between disease severity and hypophosphatemia as well as oxygenation index.Results There were statistically significant differences(P<0.05)in CRP,oxygenation index,serum potassium,serum phosphorus and the incidence of hypophosphatemia between the severe group and the mild group.There were no significant difference(P>0.05)in terms of gender,age,body mass index,co-morbidities,lymphocyte count,alanine aminotransferase,creatinine,brain natriuretic peptide,interleukin-6,serum calcium,serum chlorine and serum sodium between two groups.Logistic regression analysis showed that serum phosphorus and hypophosphatemia were independent risk factors for CAP in the elderly(P<0.05).Spearman correlation analysis showed that the severity of disease was positively correlated with hypophosphatemia(r=0.520,P<0.05),oxygenation index was negatively correlated with hypophosphatemia(r=-0.385,P=0.001),and oxygenation index was negatively correlated with disease severity(r=-0.695,P<0.05).The number of cases using mechanical ventilation,ICU admissions,severe cases and in-hospital deaths were significantly higher in the hypophosphatemia group compared to non-hypophosphatemia group(P<0.05).Conclusion Elderly CAP patients present with low blood phosphorus levels,which are closely related to prognosis and hypophosphatemia.
作者
杜鹏
王玲
杨冠民
段学祥
DU Peng;WANG Ling;YANG Guan-min(Qihe County Center for Disease Control and Prevention,Qihe 251100,China.)
出处
《医师在线》
2023年第8期6-9,共4页
Journal of Doctors Online
关键词
血清磷水平
老年社区获得性肺炎
病情及预后
血气分析
Serum phosphorus level
Community-acquired pneumonia in the elderly
Disease and prognosis
Blood gas analysis
