2018—2019年内蒙古自治区老年病毒性肺炎的流行病学分析

Epidemiological analysis of elderly viral pneumonia in Inner Mongolia Autonomous Region in 2018-2019

目的探讨内蒙古自治区老年病毒性肺炎流行病学特征并分析病原学分布,为防治老年病毒性肺炎提供参考。方法选取2018年1月至2019年12月内蒙古自治区人民医院收治的老年肺炎患者797例为研究对象,所有患者均经呼吸道病毒病原学检测,根据检测结果分为阳性组345例、阴性组452例。分析阳性组患者病原学特征,比较两组合并基础疾病情况、临床特征、实验室指标、不同季节分布情况。结果阳性组345例患者中单一病毒感染319例,占92.46%,主要为流感病毒221例,占比64.06%,其次为副流感病毒42例,占比为12.17%;合并两种及以上病毒感染26例,占7.54%,主要为流感病毒+副流感病毒15例,占比4.35%;阳性组患者合并糖尿病、心脑血管病、恶性肿瘤率均明显高于阴性组(P<0.01);两组患者临床特征均以发热、咳嗽为主,但比较差异无统计学意义(P>0.05);阳性组患者Lym高于阴性组(P<0.01),CRP、PCT均明显低于阴性组(P<0.01);阳性组患者冬季发病率明显高于阴性组(P<0.01),春季明显低于阴性组(P<0.01)。结论内蒙古自治区老年病毒性肺炎合并基础疾病多,临床症状不典型,冬季高发,病毒病原学多以流感病毒、副流感病毒感染为主,鉴别病毒性肺炎可参考Lym、CRP、PCT等实验室指标。

Objective To investigate the epidemiological characteristics of elderly viral pneumonia in Inner Mongolia Autonomous Region from 2018 to 2019 and analyze the pathogenic distribution,and to provide reference for the prevention and treatment of elderly viral pneumonia.Methods A total of 797 elderly patients with viral pneumonia admitted to our hospital from January 2018 to December 2019 were enrolled as the research subjects.All patients were tested for respiratory viral pathogens.According to the test results,the patients were divided into two groups,positive group(n=345)and negative group(n=452).The pathogenic characteristics of patients in the positive group were analyzed.The combined basic diseases,clinical characteristics,laboratory indicators,and distribution of viral pneumonia in different seasons were compared between the two groups.Results Among the 345 patients in the positive group,319(92.46%)were infected with single virus,mainly influenza virus(n=221,64.06%),followed by parainfluenza virus(n=42,12.17%).There were 26 cases infected with two or more viruses,accounting for 7.54%,mainly influenza virus+parainfluenza virus(n=15,4.35%).The proportion of patients complicated with diabetes,cardiovascular and cerebrovascular diseases,and malignant tumors in the positive group was significantly higher than that in the negative group(P<0.05).The clinical characteristics of both groups were mainly fever and cough,with no significant difference(P>0.05).The Lym value of the positive group was higher than that of the negative group(P<0.05),while CRP and PCT values were significantly lower than those of the negative group(P<0.05).The incidence rate in the positive group was significantly higher than that in the negative group in winter(P<0.01),and it was significantly lower than that in the negative group in spring(P<0.01).Conclusion In Inner Mongolia Autonomous Region,elderly patients with viral pneumonia are complicated with many basic diseases,but the clinical symptoms are not typical,with high incidence in winter.The infection is mainly caused by influenza virus and parainfluenza virus.Laboratory indicators such as Lym,CRP and PCT can be used to identify viral pneumonia.