老年痴呆患者合并肺部感染发生率与危险因素分析

Incidence and risk factors for pulmonary infections in senile dementia patients

目的探讨老年痴呆患者合并肺部感染的高危因素,为临床预防治疗提供依据。方法选择2014年1月-2015年12月在医院住院的老年痴呆患者126例为研究对象,其中血管性痴呆(VD)患者66例,阿尔茨海默病(AD)患者60例;记录患者的一般资料及临床资料,分析老年痴呆患者合并肺部感染率及危险因素。结果 126例患者中42例发生肺部感染,感染率为33.3%,其中上呼吸道感染10例,下呼吸道感染32例;多因素分析结果显示:糖尿病、进食困难、长期卧床、吸烟史、不合理使用抗菌药物、合并肿瘤、低蛋白血症是血管性痴呆患者合并肺部感染的独立危险因素;糖尿病、吸烟史、不合理使用抗菌药物、病程长、合并肿瘤、低蛋白血症是阿尔茨海默病患者合并肺部感染的独立危险因素。结论老年痴呆患者容易并发肺部感染,不同痴呆患者并发肺部感染的危险因素存在差异,而糖尿病、不合理使用抗菌药物、合并肿瘤及低蛋白血症等是血管性痴呆与阿尔茨海默病共同的独立危险因素。

OBJECTIVE To explore the high risk factor for pulmonary infections in senile dementia patients so as to provide guidance for clinical prevention and treatment. METHODS A total of 126 senile dementia patients who were hospitalized from Jan 2014 to Dec 2015 were recruited as the study objects, including 66 cases of vascular dementia （VD） and 60 cases of Alzheime（s disease （AD）. The baseline data and clinical data of the patients were recorded, and the risk factors for the pulmonary infection in the senile dementia patients were observed, RESULTS Of the 126 patients, 42 had the pulmonary infection, with the infection rate 33.3~, including 10 eases of upper respiratory tract infection and 32 cases of lower respiratory tract infection. Multivariate analysis indicated that the independent risk factors for the pulmonary infection in the VD patients included diabetic mellitus, difficulty in feeding, long bedridden time, smoking history, unreasonable use of antibiotics, complication with tumor, and hypoproteinemia; the independent risk factors for the pulmonary infection in the AD patients included diabetic mellitus, smoking his- tory, unreasonable use of antibiotics, long disease course, complication with tumor, and hypoproteinemia. CONCLUSION The senile dementia patients tend to be complicated with the pulmonary infection; the patients with different types of dementia vary in the risk factors for the pulmonary infection. The diabetic mellitus, unreasonable use of antibiotics, complication with tumor, and hypoproteinemia are the shared independent risk factors for the pulmonary infection in the VD patients and AD patients.