摘要
目的：探讨大肠埃希菌血流感染（Ecoli bloodstreaminfection，ESI）老年患者的临床指标价值及预后的差异。方法：回顾性分析比较2011年1月-2013年12月入住聊城市人民医院的226例老年和168例中青年ESI患者的临床资料。结果：与中青年组相比，老年组患者入住内科病区及合并呼吸道感染的比例明显增加，合并腹部外伤比例明显降低ICU入住时间≥5天、机械通气、中心静脉置管等危险因素在老年组更为常见（P〈0．05）。老年组与中青年组血糖分别为（9．0±5．0；6．6±2．3）、降钙素原（28．9±5．6；16．7±6．4）、多重病原菌血流感染（15．9％；6．5％）、APACHE Ⅱ评分（20．1±8．2；14．9±7．4）、SOFA评分（7．5±4．3；4．6±3．8），住院病死率（20．3％；4．7％）和90d病死率（18．5％；7．1％）均明显高于中青年组（P〈0．01）。结论：与中青年患者相比，老年患者ESI有其特殊的病原学特征、危险因素和抗菌药物应用特点，且患者预后较差。
Objective： To investigate the differences of clinical characteristics and prognosis between elderly patients and younger and middle-aged patients with Ecoli bloodstream infection （ESI） . Methods： The clinical information of 226 elderly patients and 168 younger and middle-aged patients with ESI in Liaocheng People＇s Hospital from January 2011 to June 20l 3 were retrospectively reviewed. Results： Compared with younger and middle-aged patients, the elderly patients were associated with more incidence of physican clinic, respiratory tract infection and more often to undergo intensive care unit admission, mechanical ventilation and central venous catheterization （P〈0.05）. Compared with younger and middle-aged group, elderly patients had significant higher serum glucose（9.0±5.0 vs.6.6±2.3）, serum PCT（28.9±5.6 vs.16.7±6.4）, Acute Physiology and Chronic Health Evaluation [I score （20.1± 8.2 vs.14.9±7.4）, Sequential Organ Failure Assessment score （7.5±4.3 vs.4.6±3.8） and hospital mortality （37.2% vs.18.3%） （P〈0.01）. Conclusion： Compared with younger and middle-aged group, the elderly ESI patients showed different pathogen features, risk factors, and antifungal exposure, with poorer prognosis in elderly ESI patients.
出处
《医学检验与临床》
2016年第6期32-35,共4页
Medical Laboratory Science and Clinics
