肺部感染与老年多器官功能衰竭的研究  

Relationship of lung infection and multiple organ failure in the elderly.

作　　者：卢才义[1] 王士雯[1] 赵玉生[1] 魏璇[2] 黄从春[2] 薛桥[1] 晏沐阳[1] 刘玲玲[1] 李玉峰[1] 施伟伟[1] 张文莉[1] 

机构地区：[1]解放军总医院老年心血管病研究所,北京100853 [2]空军总医院心内科,北京100036

出　　处：《中国实用内科杂志：临床前沿版》2006年第2期259-261,共3页

基　　金：国家重点基础研究发展规划基金资助(No.TG2000057004)

摘　　要：目的探讨肺部感染在老年多器官功能衰竭中的作用。方法回顾分析2000-01-01-2001-12-31，入住解放军总医院老年心血管病研究所和空军总医院心内科，年龄≥65岁的5组连续住院患者的临床资料：急性单纯肺部感染、以急性肺水肿为首发表现的肺部感染、慢性支气管炎（慢支）合并肺部感染、慢性心力衰竭（心衰）合并肺部感染、慢支和慢性心衰合并肺部感染。结果68例患者年龄（72．5±7．6）岁，急性单纯肺部感染3例（4％），以急性肺水肿为首发表现者12例（18％），慢支合并肺部感染16例（24％），慢性心衰合并肺部感染15例（22％），慢支和慢性心衰合并肺部感染22例（32％）。因肺部感染发展为多器官功能衰竭25例（37％），主要发生于已有慢支和（或）慢性心衰者（23例，34％）。伴发性肺部感染病死率高于非伴发性肺部感染（7．4％对0％，P〈0．05）。结论慢支和（或）慢性心衰老年人伴发肺部感染易导致多器官功能衰竭。老年人肺部感染可以急性左心衰为首发表现。控制感染、缓解气道痉挛和纠正缺氧是预防老年人肺部感染多器官功能衰竭的重要措施。Objective The aim of the study is to explore the relationship of lung infection （LI） and multiple organ failure in the elderly （MOFE） . Methods Consecutive patients , who were admitted to the Institute of Geriatric Cardiovascular Diseases of the PLA General Hospital and the Endocardial Department of the Air Force General Hospital, withage≥65 years old were enrolled into 5 groups retrospectively by following criteria： acute LI alone, LI with the first presentation of acute lung edema, chronic bronchitis complicated with LI, chronic heart failure complicated with LI, and nic bronchitis and heart failure complicated with LI. Results Sixty - eight patients were selected of （72. 5 ± 7.6） years old （ 38 male） . There were 4 cases of pure LI （4%）, 12 cases of LI firstly presented with the symptoms of acute lung e dema （ 18% ）, 16 cases of LI complicated with chronic bronchitis （24%）, 15 cases of LI based on chronic heart failure （22%） and 22 cases of LI complicated with chronic bronchitis and heart failure （32%） . LI initiated MOFE in 25 cases （37%） . Most of them were developed on the basis of chronic bronchitis and/or heart failure （34%） . Mortality of secondary LI was higher than that of the primary LI （7.4% VS 0%, P 〈 0. 05） . Conclusion Secondary LI based on chronic bronchitis and/or heart failure frequently initiates MOFE. Acute lung edema could be the first presentation of LI in the elderly. LI control, bronchus spasm relief and hypoxemia correction are important measures to prevent MOFE.

关 键 词：肺部感染 多器官功能衰竭 

分 类 号：R5[医药卫生—内科学]