重症肺炎合并谵妄的血钙水平及谵妄的影响因素

Serum calcium level and influencing factors of delirium in patients with severe pneumonia

目的探讨老年重症肺炎合并谵妄患者的血钙水平及发生谵妄的影响因素。方法选取2017年4月至2018年3月就诊于华北理工大学附属医院的老年重症肺炎患者100例,依据是否发生谵妄将患者分为谵妄组(22例)和对照组(未发生谵妄,78例),分析两组患者电解质化验结果中血钾、血钠、血钙的浓度及重症肺炎合并谵妄患者的影响因素。结果谵妄组失眠病史、脑卒中病史、心功能不全病史、痴呆病史高于对照组,差异有统计学意义(P<0.05)。谵妄组血钙水平低于对照组,差异有统计学意义[(2.21±0.15)mmol/L vs(2.35±0.09)mmol/L,t=5.534,P=0.000],而两组血钾、血钠水平差异无统计学意义(P>0.05)。Logistic回归分析显示,低钙血症、失眠、脑卒中、痴呆、心功能不全是老年重症肺炎合并谵妄的独立危险因素(P<0.05)。结论老年重症肺炎合并谵妄患者血钙水平较低,低钙血症、失眠、脑卒中、痴呆、心功能不全是重症肺炎合并谵妄发生的危险因素。

Objective To analyze the level of serum calcium and the influencing factors of delirium in elderly patients with severe pneumonia complicated with delirium.Methods A total of 100 elderly patients with severe pneumonia admitted to the Affiliated Hospital of North China University of Technology from April 2017 to March 2018 were selected and divided into delirium group(n=22)and control group(n=78)according to whether delirium occurred.The concentrations of potassium(K),sodium(Na)and calcium(Ca)ions and the influencing factors of delirium were analyzed in two groups.Results After controlling the effects of gender,age,course of disease,body mass index,blood pressure,nutritional level,drinking history,diabetes history,coronary heart disease history,body temperature,white blood cells and blood glucose(P>0.05),the histories of insomnia,stroke,heart failure and dementia in delirium group were significantly higher than those in control group(P<0.05).The level of Ca2+in delirium group was lower than that in control group[(2.21±0.15)mmol/L vs(2.35±0.09)mmol/L,t=5.534,P=0.000],but there were no significant differences in serum potassium and sodium levels(P>0.05).Logistic regression analysis showed that hypocalcemia,insomnia,stroke,dementia,cardiac insufficiency were the independent risk factors of delirium in elderly patients with severe pneumonia(P<0.05).Conclusion In elderly patients with severe pneumonia complicated with delirium,the level of serum calcium is lower,and hypocalcemia,insomnia,stroke,dementia and cardiac dysfunction are the influencing factors of delirium.