老年社区获得性肺炎的临床特征及相关原因探讨

The clinical characteristics and related causes of community acquired pneumonia in the elderly patients

目的探讨老年患者社区获得性肺炎产生的临床特征及相关原因。方法选取66例老年社区获得性肺炎患者作为观察组,按照1:1比例选择同期中青年社区获得性肺炎患者66例作为对照组,比较两组患者基础疾病、临床表现、实验室检查、影像学表现、治疗及预后等方面的差异。结果 (1)观察组合并心脑血管疾病的比例为74.24%,恶心、呕吐、神志改变45.45%,病变累积双侧30.30%,胸腔积液18.18%,自动出院及死亡10.61%,均显著高于对照组的27.27%,13.63%,13.63%,4.54%和0.00%;观察组发热、咳嗽比例为77.27%,治愈率88.00%,均低于对照组的90.91%和100.00%,差异均有统计学意义(P<0.05)。(2)观察组入院时平均体温(37.47±0.24)℃,低于对照组的(38.13±0.19)℃;白细胞水平(7.55±3.38)×109/L,低于对照组的(11.23±2.43)×109/L;平均住院日(19.13±3.56)d,长于对照组的(12.32±2.45)d,差异均有统计学意义(P<0.05)。(3)Logistic多因素分析显示长期使用抗生素,心脑血管疾病,糖尿病,恶性肿瘤及长期使用激素是老年社区获得性肺炎患者重要的危险因素。结论老年社区获得性肺炎临床特点不典型,预后较差。临床工作中应针对致病的危险因素进行预防和治疗。

Objective To explore the clinical characteristics and related causes of community acquired pneumonia in elderly patients.Methods Sixty-six cases of elderly patients with community acquired pneumonia were chosen for the observation group,66 youth patients with community acquired pneumonia during the same pe-riod as the control group,the differences between two groups with underlying diseases,clinical manifestations,la-boratory examination,imaging features,treatment and prognosis were compared.Results The proportion of car-diovascular-cerebrovascular diseases in observation group was 74.24%,nausea,vomiting,altered mental status were 45.45%,the cumulative was 30.30%,bilateral lesions,pleural effusion were 18.18%,automatically dis-charges and deaths were 10.61%;were higher than 27.27%,13.63%,13.63%,4.54% and 0% in control group;the ratio of fever and cough were 77.27%,the cure rate was 88% in observation group were lower than that the control group(90.91% and 100%),the differences were significant(P <0.05).2.The observation group's average temperature (37.47 ±0.24)℃was lower than the control group (38.13 ±0.19)℃;white blood cells (7.55 ±3.38) ×109/L,were lower than the control group (11.23 ±2.43) ×109/L;average length of hospitalization (19.13 ±3.56)d,was longer than the control group (12.32 ±2.45) d,the differences were statistically significant(P<0.05).Logistic multivariate analysis showed that long-term use of antibiotics, diabetes, cardiovascular and cerebrovascular diseases, malignant tumor and the long-term use of hormone were important risk factors of elderly patients with community acquired pneumonia .Conclusion The elderly patients with community acquired pneumonia is not typical,the prognosis is poor.