上海市老年人社区获得性肺炎危险因素的病例-对照研究  

Case-control study of risk factors for community acquired pneumonia among old persons in Shanghai City

作　　者：白庆瑞[1] 徐飚[2] 孙铁英[3] 张涛[2] 何礼贤[4] 

机构地区：[1]上海市疾病预防控制中心,上海200336 [2]复旦大学公共卫生学院 [3]北京医院呼吸内科 [4]复旦大学附属中山医院呼吸内科

出　　处：《卫生研究》2007年第5期587-590,共4页Journal of Hygiene Research

基　　金：国家十五科技攻关课题项目(No.2001BA702B05)

摘　　要：目的探索上海市老年人社区获得性肺炎发病的危险因素。方法采用病例-对照研究设计,病例来源于2004年2月至5月在上海市新华街道和半淞园街道65岁及以上老年人中调查发现的社区获得性肺炎确诊病例,以及同期一家二级综合医院内科门诊就诊的65岁以上的社区获得性肺炎确诊病例。对照在上述两街道的所有65岁以上的非CAP患者人群中随机抽取。采用统一设计的调查表,以面对面问卷调查方式收集信息。资料统计分析主要采用χ2检验和非条件logistic回归模型等统计方法。结果共搜集病例128例,对照306例,结果发现5项因素可能与社区获得性肺炎有关,它们分别为:年龄(OR=1.049,95%CI1.007～1.093)、吸烟(OR=2.317,95%CI1.224～4.386)、日常生活自理能力(ADL)评分(OR=0.599,95%CI0.474～0.755)、呼吸系统疾病(OR=6.295,95%CI3.738～10.604)、和非肺部恶性肿瘤(OR=4.332,95%CI1.340～14.005)。结论高龄、吸烟、活动能力差并患有慢性呼吸系统疾病或恶性肿瘤的老年人容易发生社区获得性肺炎,因此具有这些特征的老年人应特别注意对社区获得性肺炎的预防。Objective To explore the risk factors of community acquired pneumonia （CAP） among persons at the age of equal to or older than 65 years old in Shanghai City. Methods A case-control study was carried out to study the risk factors of CAP. Some of the CAP cases were recruited from the survey in Xinhua Community and Bansongyuan Community, others were from a hospital＇ s outpatients. The controls were taken sample from the two communities. All the cases and controls were 65 years old or above. The cases and controls were interviewed with a structured questionnaire. Multivariate non-conditional logistic regression and chi-square test were used to analyze the data. Results 128 cases and 306 controls were enrolled for the case-control study. Through the multivariate logistic regression, it was found that the risk of CAP was increased with regard to age （ OR = 1.049,95% C1 1.007 - 1.093）, smoking （ OR = 2.317,95% CI 1.224 - 4.386）, ADL score （ OR = 0.599, 95% CI 0.474 - 0.755）, chronic respiratory system diseases （ OR = 6.295,95% CI 3.738 - 10.604） and non lung cancer （ OR = 4.332,95% CI 1.340 - 14.005）. Conclusion Old age, smoking, lower ADL score, chronic respiratory system diseases and cancer may be the risk factors of CAP. The effective measures should be taken to prevent community acquired pneumonia of old persons with these characteristics.

关 键 词：社区获得性肺炎 老年人 危险因素 

分 类 号：R161.7[医药卫生—公共卫生与预防医学] R195.4