85例老年肺炎合并病毒感染患考临床特点分析

Analysis of clinical features of 85 elderly patients with pneumonia complicating by virus infection

目的探讨老年肺炎患者呼吸道病毒感染的流行病学特征及临床特点,以提高老年病毒性肺炎的诊治水平:方法回顾分析2016年1月至2017年1月广东省中医院就诊的呼吸道病毒检测阳性的老年肺炎患者的相关临床数据,建立数据库,应用SPSS 17.0软件进行统计学分析:结果经病毒检测,85例纳入研究的老年肺炎合并病毒感染患者中副流感病毒感染数量最多,有39例,甲型流感病毒感染为23例85例患者中96.47%有基础疾病.其中高血压53例(62.35%)、冠心病20例( 23.53%)、脑梗死后遗症20例( 23.53%)、2型糖尿病19例(22.35%)、慢性心功能不全14例(16.47%) 85例患者中出现咳嗽、咳痰症状的有73例(85.88%),其他症状分别为气促40例(47.06%)、胸闷13例(15.29%)、胸痛3例(3.53%)。85例患者中白细胞升高的有41例(48.24%),谷草转氨酶升高的患者有20例(23.53%),肌酹升高的有47例(55.29%), D-2聚体升高的患者有77例(90.59%),降钙素原升高的患者有76例(89.41%), hs-CRP升高的患者有83例(97.65%) c结论85例老年肺炎合并病毒感染患者中,大部分伴有基础疾病;部分患者症状不典型.呼吸道症状以咳嗽、咳痰多见.并可伴有气促、胸闷、胸痛等症状;实验室检査发现hs-CRP.降钙素原和D-2聚体的升高与老年肺炎合并病毒感染有一定相关性。

Objective To explore the epidemiological and clinical characteristics of respiratory virus infection in elderly patients with pneumonia, to improve the diagnosis and treatment of elderly patients with viral pneumonia. Methods The relevant clinical data of elderly pneumonia patients with positive respiratory virus test admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2016 to January 2017 were retrospectively analyzed. A database was established and SPSS17.0 software was used for statistical analysis. Results By virus detection, the number of cases of parainfluenza virus infection was the highest (39 cases) among 85 elderly patients with pneumonia complicating by virus infection included in the study, and 23 cases of influenza A virus infectio n. Among the 85 patients, 96.47% had basic diseases, in eluding 53 cases of hypertension (62.35%), 20 cases of coronary heart disease (23.53%), 20 cases of sequelae of cerebral infarction (23.53%), 19 cases of type 2 diabetes (22.35%), and 14 cases of chronic heart insufficiency (16.47%). Among the 85 patients, 73 cases (85.88%) presented cough and expectoration, and the other symptoms were shortness of breath in 40 cases (47.06%), chest distress in 13 cases (15.29%), and chest pain in 3 cases (3.53%). Of the 85 patients, 41 cases (48.24%) had elevated leukocytes, 20 cases (23.53%) had elevated glutamate transaminase, 47 cases (55.29%) had elevated creatinine, 77 cases (90.59%) had elevated D-dimer level, 76 cases (89.41%) had elevated procalcitonin, and 83 cases (97.65%) had elevated hs-CRP. Conclusions Of the 85 cases of elderly patients with pneumonia complicating by virus infection, most of them were accompanied by basic diseases, and some of them had atypical symptoms, cough and expectoration were more common among respiratory symptoms, and may be accompanied by shortness of breath, chest tightness, chest pain, and other symptoms. Laboratory examination showed that the increase of hs-CRP, procalcitonin, and D-dimer levels were correlated with elderly patients with pneumonia complicating by virus infection.