老年肺炎住院患者流行病学特征、基础疾病与诊治情况

doi:10.3969/j.issn.1004-583X.2021.03.008

摘要/Abstract

摘要：

目的调查老年社区获得性肺炎(CAP)住院患者基础疾病、病原学特征与治疗措施,分析影响住院时间的因素。方法选取在我院住院治疗的CAP患者400例,按照年龄分为老年组(≥65岁、274例)与非老年组(<65岁、126例),比较两组基础疾病、病原学特征与治疗措施,采用Logistic回归分析老年组住院时间的影响因素。结果老年组高血压(35.04%)、糖尿病(20.44%)、冠心病(12.04%)、慢性心力衰竭(9.85%)、慢性阻塞性肺疾病COPD(15.69%)、慢性肾脏疾病(12.41%)高于非老年组(P<0.05);老年组细菌(28.83%)、真菌(18.98%)感染发生率高于非老年组(P<0.05);老年组检出2种病原体患者比例(16.06%)高于非老年组(P<0.05);多因素Logistic分析显示,年龄≥80岁(OR=6.477)、合并恶性肿瘤(OR=8.642)、合并慢性心力衰竭(OR=14.625)、使用糖皮质激素(OR=6.729)是影响老年CAP患者住院时间的独立影响因素(P<0.05)。结论老年CAP患者大部分合并多种基础疾病,高龄(≥80岁)、合并恶性肿瘤、合并慢性心力衰竭及使用糖皮质激素是影响患者住院时间的独立影响因素。

关键词: 肺炎, 老年, 病原体, 住院时间, 流行病学

Abstract:

Objective To investigate underlying diseases, etiological characteristics and treatments in elderly hospitalized patients with community-acquired pneumonia (CAP), and analyze the factors related to the length of hospital stay of the patients. Methods A total of 400 CAP patients who were hospitalized in our hospital were enrolled and assigned into the elderly group(n=274, ages ≥65 years old) and the non-elderly group(n=126, ages <65 years old) by age. The underlying diseases, etiological characteristics and treatment measures of the two groups were compared, and the influencing factors of the length of hospital stay in the elderly group were analyzed by Logistic regression. Results The indicators of hypertension (35.04%), diabetes (20.44%), coronary heart disease (12.04%), chronic heart failure (9.85%), chronic obstructive pulmonary disease (COPD)(15.69%), and chronic kidney disease (12.41%) of the elderly group were all higher than those of the non-elderly group(P<0.05). The indicators of bacteria (28.83%) and fungi (18.98%) infection in the elderly group were higher than those in the non-elderly group (P<0.05). The proportion of patients with 2 pathogens detected in the elderly group (16.06%) was higher than that in the non-elderly group (P<0.05); Multivariate Logistic analysis showed that, ages≥80 years old (OR=6.477), complicated malignant tumors (OR=8.642), complicated chronic heart failure (OR=14.625), glucocorticoid treatment (OR=6.729) were the independent influencing factors of the length of hospital stay of the elderly patients with CAP (P<0.05). Conclusion Most elderly patients with CAP were associated with a variety of underlying diseases, and elderly (ages ≥80 years old), complicated malignant tumors, complicated chronic heart failure, use of glucocorticoids are independent factors influencing the length of hospital stay.

Key words: pneumonia, elderly, pathogens, length of hospital stay, epidemiology

中图分类号:

R563.1

蔡木泾, 陈兢兢, 黄如坤, 蔡小妮, 郑若贤. 老年肺炎住院患者流行病学特征、基础疾病与诊治情况[J]. 临床荟萃, 2021, 36(3): 229-232.

Cai Mujing, Chen Jingjing, Huang Rukun, Cai Xiaoni, Zheng Ruoxian. Epidemiological characteristics, underlying diseases and treatments of elderly hospitalized patients with pneumonia[J]. Clinical Focus, 2021, 36(3): 229-232.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.03.008

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I3/229

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参考文献 21

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组别	例数	性别[例(%)]		年龄 (岁)	吸烟史 [例(%)]	饮酒史 [例(%)]	居住地为城镇 [例(%)]	付费方式为医保 [例(%)]
组别	例数	男	女	年龄 (岁)	吸烟史 [例(%)]	饮酒史 [例(%)]	居住地为城镇 [例(%)]	付费方式为医保 [例(%)]
老年组	274	162(59.12)	112(40.88)	67.32±6.85	103(37.59)	26(9.49)	202(73.72)	253(92.34)
非老年组	126	79(62.70)	47(37.30)	56.59±5.27	44(34.92)	13(10.32)	95(75.40)	118(93.65)
t/χ²值		0.460		15.586	0.265	0.067	0.127	0.222
P值		0.497		<0.01	0.607	0.795	0.722	0.638

组别	例数	性别[例(%)]		年龄 (岁)	吸烟史 [例(%)]	饮酒史 [例(%)]	居住地为城镇 [例(%)]	付费方式为医保 [例(%)]
组别	例数	男	女	年龄 (岁)	吸烟史 [例(%)]	饮酒史 [例(%)]	居住地为城镇 [例(%)]	付费方式为医保 [例(%)]
老年组	274	162(59.12)	112(40.88)	67.32±6.85	103(37.59)	26(9.49)	202(73.72)	253(92.34)
非老年组	126	79(62.70)	47(37.30)	56.59±5.27	44(34.92)	13(10.32)	95(75.40)	118(93.65)
t/χ²值		0.460		15.586	0.265	0.067	0.127	0.222
P值		0.497		<0.01	0.607	0.795	0.722	0.638

组别	例数	高血压	糖尿病	恶性肿瘤	冠心病	慢性心力衰竭	COPD	支气管扩张	慢性肾脏疾病	肝硬化
老年组	274	96(35.04)	56(20.44)	29(10.58)	33(12.04)	27(9.85)	43(15.69)	14(5.11)	34(12.41)	3(1.09)
非老年组	126	28(22.22)	11(8.73)	10(7.94)	2(1.59)	1(0.79)	3(2.38)	4(3.17)	7(5.56)	1(0.79)
t/χ²值		6.626	8.484	0.687	11.819	10.884	15.029	0.752	4.406	0.079
P值		0.010	0.004	0.407	0.001	0.001	<0.01	0.386	0.036	0.779

组别	例数	高血压	糖尿病	恶性肿瘤	冠心病	慢性心力衰竭	COPD	支气管扩张	慢性肾脏疾病	肝硬化
老年组	274	96(35.04)	56(20.44)	29(10.58)	33(12.04)	27(9.85)	43(15.69)	14(5.11)	34(12.41)	3(1.09)
非老年组	126	28(22.22)	11(8.73)	10(7.94)	2(1.59)	1(0.79)	3(2.38)	4(3.17)	7(5.56)	1(0.79)
t/χ²值		6.626	8.484	0.687	11.819	10.884	15.029	0.752	4.406	0.079
P值		0.010	0.004	0.407	0.001	0.001	<0.01	0.386	0.036	0.779

组别	例数	细菌	真菌	流感病毒	非流感病毒	支原体	未检出
老年组	274	79(28.83)	52(18.98)	18(6.57)	13(4.74)	18(6.57)	138(50.36)
非老年组	126	24(19.51)	8(6.35)	16(12.70)	6(4.76)	7(5.56)	58(46.03)
t/χ²值		4.322	10.796	4.169	0.000	0.151	0.649
P值		0.038	0.001	0.041	0.994	0.697	0.421