老年人急性感染性腹泻的临床特点

Clinical characteristics of acute infections diarrhea in the aged

目的 探讨老年急性感染性腹泻的临床特点。方法 对 1990年 1月至 2000年 5月间收治的急性感染性腹泻作顺顾性研究，比较老年组和中青年组患者的临床特点。结果 与中青年组比较，老年组病情重 (51. 5％ vs 35. 2％ )，低血压 (19. 8％ vs 11. 6％ )、代谢性酸中毒 (64. 4％ vs 41. 9％ )、低钾血症 (38. 6％ vs 16. 5％ )、 BUN升高 (20. 8％ vs 12. 3％ )、 Cr升高 (10. 9％ vs 2. 7％ )、心肌酶升高 (63. 2％ vs 28. 1％ )、白细胞计数增多 (38. 6％ vs 26. 1％ )、心电图异常 (37. 9％ vs 19. 6％ )，尿常规异常 (31. 7％ vs 11. 8％ )等的比例显著升高，而患病率 (19. 9％ vs 80. 1％ )、发热 (31. 7％ vs 49. 5％ )的比例显著下降，伴随症多 (60. 4％ vs 11. 6％ )，住院天数长 (5. 37± 3. 41vs 4. 25± 2. 61)。结论 老年人急性感染性腹泻患病率低，病情较中青年重，易发生低血压、低钾血症、代谢性酸中毒、肾脏及心脏损害等并发症，发热不明显，伴随症状多，恢复较中青年人慢，临床上应注意判断病情程序，及早治疗。

Objective:The aim of this study is to investigate clinical characteristics of actue infections diarrhea in the aged.Methods:Aretrospective study was performed on all patients admitted to our hospital from 1990 to 2000.Clinical characteristics were compared between the young and aged group.Results:Compared with the young group,the old men's illness is much more serious(51.5％ vs35.2％ ),The proportion of the old men s illness cases was much increased,such as:hypotension(19.8％ vs11.6％ ),metabolicacidosis(64.4％ vs41.9％ ),hypokalemia(38.6％ vs 16.5％ ),BUN rised(20.8％ vs 12.3％ ),Cr rised(10.9％ vs 2.7％ ),myocardicale enzyme rised(63.2％ vs28.1％ )and morbid rate(19.9％ vs80.1％ ),white blood cell cout rised(38.6％ vs 26.1％ ).ECG(37.9％ vs 19.6％ )and routine urinalysis were abnorma(31.7％ vs 11.8％ )But their proportion of fever was much descent,the comorbidities was more(60.4％ vs 11.6％ ),and they have had much more days in hospitalized(5.37± 3.41vs 4.25± 2.61).Conclusions:Their morbid rate of acute infection was lower than the young group.Their case was much serious.And they should easily had hypotension,hypokalemia,metabo－ licacidosis,kidney and heart's harm etc.And theirillness recovery was much solwer.So we could pay much more attenion and study their iilness' different change in clinical diagnosis,and cure them in time.