社区获得性肺炎合并心衰的危险因素及管理

Risk factors and chronic disease management of community acquired pneumonia complicated with heart failure

目的分析社区获得性肺炎合并心力衰竭患者的危险因素及慢病管理。方法选择我院2020年1月至10月间住院治疗的100例社区获得性肺炎患者,其中社区获得性肺炎合并心力衰竭者43例作为观察组,无合并心力衰竭者57例为对照组,比较两组患者的潜在危险因素,包括年龄、吸烟、慢性阻塞性肺疾病(COPD)、高血压、糖尿病、肾功能不全。结果患者共100例,合并心力衰竭者43例作为观察组,男性21例,女性22例,年龄61-90岁(77.28±10.91岁);未合并心力衰竭者57例为对照组,其中男性42例,女性15例,年龄24-98岁(73.42±15.64岁)。合并心衰的43例患者进行超声心动图检测,其中12例患者的LVEF<50%,为左室收缩功能不全。患者中31例LVEF>50%,为左室舒张功能不全。经Logistic回归分析,吸烟、器质性心脏病、高血压、糖尿病、肾功能不全、年龄、慢性阻塞性肺病为社区获得性肺炎合并心衰患者的独立危险因素(p<0.05)。结论吸烟、慢性阻塞性肺疾病(COPD)、长期卧床、高血压、糖尿病、肾功能不全、高龄均是社区获得性肺炎合并心力衰竭的危险因素,可通过加强管理降低患病率,对预防社区获得性肺炎合并心衰具有指导意义。

Objective To analyze the risk factors and chronic disease management of community-acquired pneumonia patients with heart failure.Methods One hundred patients with commnity-acquired pneumonia,who were collected from Beijing Changping Hospital of Chinese Medicine from January 2020 to October 2020,were divided into two groups:43 cases with heart failure as observation group,and 57 cases without heart failure as control group.The risk factors were compared in two groups,in which included age,smoking,chronic obstructive pulmonary disease(COPD),hypertension,diabetes,renal insufficiency.Results A total of 100 patients,43 patients with heart failure as the observation group,21 males and 22 females,aged 61-90 years(77.28±10.91 years);57 cases without heart failure were the control group,of which There were 42 males and 15 females,aged 24-98 years(73.42±15.64 years).Forty-three patients with heart failure underwent echocardiography.Among them,12 patients had LVEF<50%,indicating left ventricular systolic insufficiency.31 patients with LVEF>50%were left ventricular diastolic dysfunction.Logistic regression analysis showed that smoking,organic heart disease,hypertension,diabetes,renal insufficiency,age,and chronic obstructive pulmonary disease were independent risk factors for patients with community-acquired pneumonia and heart failure(p<0.05).Conclusions Smoking,chronic obstructive pulmonary disease(COPD),long-term bed rest,hypertension,diabetes,renal insufficiency,and advanced age are all risk factors for community-acquired pneumonia complicated with heart failure.Strengthening management can reduce the prevalence and prevent Community-acquired pneumonia with heart failure has guiding significance.