老年社区获得性肺炎预后危险因素分析

Risk factors related to outcomes of community-acquired pneumonia in elderly patients

关键词:  社区获得性肺炎  预后  危险因素

Key words:  community-acquired pneumonia  prognosis  risk factors

摘要:

目的 探讨影响老年社区获得性肺炎(community-acquired pneumonia,CAP)患者预后的危险因素。方法 收集140例年龄≥65岁的老年CAP患者,按预后分为死亡组(36例)、治愈组(104例)。比较两组间一般临床资料及血肌钙蛋白、白蛋白、血糖、血肌酐、白细胞、血红蛋白、C反应蛋白及D-D二聚体(D-Dimer)水平,并对组间比较有差异的因素进行多因素非条件Logistic回归分析。结果与治愈组相比,死亡组具有于高龄、合并两种以上慢性疾病、多叶肺炎(P＜0.05)等特征,死亡组血浆肌钙蛋白、血肌酐、D-Dimer及CRP水平均明显高于治愈组(P＜0.05),而血浆白蛋白水平则明显低于治愈组(P＜0.05)。非条件Logistic回归分析结果显示:年龄(P=0.011,OR0.012)、多叶肺炎(P=0.019,OR 4.377)和D-Dimer(P=0.005,OR 2.411)升高是老年社区获得性肺炎死亡的独立危险因素。结论 高龄、多肺叶炎症及血浆D-Dimer水平升高是老年CAP患者死亡的独立危险因素。重视这些临床指标有助于及早识别高危患者。

Abstract:

Objective To evaluate risk factors related to outcomes in elderly patients with community-acquired pneumonia(CAP).Methods One hundred and forty elderly patients with CAP were enrolled in this study,among whom 36cases died(dead group) and 104cases were cured(cure group).The related factors including clinical data and laboratory tests were analyzed and compared between two groups.Results Older age,more than two chronic diseases and multiple lung lobe inflammation were more common in dead group.Plasma troponin T,creatinine,D-Dimer and C-reactive protein levels were higher and albumin levels were lower in dead group than those in cure group.Multivariate logistic analysis revealed that older age,multiple lung lobe inflammation and plasma D-Dimer levels were independent predicators for death in elderly patients with CAP.Conclusion Older age,multiple lung lobe inflammation and high plasma D-Dimer levels are related to poorer outcomes of elderly patients with CAP.