老年社区获得性肺炎临床分析

Analysis of Clinical Features of Elderly Patients with Community-Acquired Pneumonia

目的:观察老年患者社区获得性肺炎(CAP)的临床及治疗现况。方法:连续入选2007年9月至2010年5月在我院呼吸科住院治疗的CAP患者432例,记录临床特点、基础疾病、并发症、病原学和治疗情况,分析年龄≥65岁与非老年患者的差异。结果:432例CAP患者中,老年人共136例(31.4%),与非老年患者比较,老年CAP患者并存基础疾病多(P<0.01)、易发生神志障碍(20%比6%,P<0.01)、呼吸衰竭(18%比7%,P<0.01)和休克(15%比7%,P<0.01);与非老年患者比较,老年CAP患者革兰阴性杆菌发生率更高(63.6%比41.6%,P<0.01),抗生素选用碳青酶烯类更多,联合用药抗感染多;老年CAP患者住院时间比非老年患者长,治疗费用也更多。结论:老年CAP患者具有并存疾病多,易发展为重症且治疗更复杂、更困难的特点。

Objective： To investigate the clinical features and treatment of elderly patients with community-acquired pneumonia（CAP）.Methods： The clinical data of 432 patients with CAP in our department from Sep,2007 to May,2010 were retrospectively reviewed.Clinical features,basic diseases,complications,aetiology,and treatment data were compared between ≥65 years old group and 65 years old group.Results： Of the 432 patients,136（31.4%） were older than 65 years.Compared with the younger group,the aged patients had a higher prevalence in comorbidities（P0.01）,listlessness（20% vs.6%,P0.01）,respiratory failure（18% vs.7%,P0.01） and shock（15% vs.7%,P0.01）.The main pathogens were Gram-negative bacilli in the aged patients,which were higher than in younger group（63.6% vs.41.6%,P0.01）.Carbapenems and multi-antibiotics therapy was more commonly used in the aged patients.The average duration of hospitalization and the average cost of hospitalization in the aged patients were also higher and more.Conclusion： The clinical features of elderly patients with CAP are more complex and severe.The treatment of the elderly patients with CAP is more difficult than that of younger ones.