老老年社区获得性肺炎44例临床分析

目的探讨老老年(≥80岁)社区获得性肺炎(CAP)的临床特点。方法回顾性分析44例老老年CAP的临床资料,使用Logistic回归分析影响病死率的危险因素。结果 44例(100%)患者均合并基础疾病,≥1种并发症37例(84.1%),临床表现不典型,实验室检查示白细胞增高27例(61.4)%,贫血23例(52.3%),经综合治疗痊愈16例(36.4%),好转15例(34.1%),死亡13例(29.5%),统计分析发现卧床、合并基础疾病的数量、合并神经系统疾病、意识障碍、营养不良、APACHEⅡ和PSI评分较高,均为影响病死率的危险因素(P<0.05,P<0.01);而卧床、休克和APACHEⅡ评分较高,为影响老老年人CAP病死率的独立危险因素(P<0.05,P<0.01)。结论老老年CAP患者临床症状、体征不典型,肺外症状多,且合并营养不良者常见,临床需加以重视。病原学以肺炎球菌和革兰阴性杆菌为主,影响老老年人CAP病死率的独立危险因素有卧床、休克和较高APACHEⅡ评分。

Clinical analysis of 44 patients with community-acquired pneumonia in very elderly

Objective To explore the clinical features of the 44 very elderly patients with community-acquired pneumonia (CAP).Methods A retrospective study was carried out to assess the clinical characteristics of 44 patients with community acquired pneumonia.The logistic regression model was applied to analyze the risk factors of mortality.Results All patients combined with fundamental diseases,which 37 cases(84.1%) with over one complication,27 cases(61.4%) with atypical clinical symptoms and white blood cell increa...