院内老年肺感染的临床及影像学特点  

Clinical and image characteristics of hospital acquired pneumonia in the elderly

作　　者：沈维敏[1] 李向阳[1] 梁红[1] 

机构地区：[1]华东医院呼吸科,上海200040

出　　处：《临床肺科杂志》2012年第1期33-34,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨老年院内获得性肺炎(HAP)的临床及影像学特征。方法收集临床确诊的老年院内肺感染67例的临床及CT、平片资料,分析其病原分布及对应的CT和临床特点,并与67例青壮年组的院内获得性肺炎进行比较。结果老年肺感染的病原体中细菌31例(46%),支原体或衣原体6例(9%),病毒感染7例(10%),结核9例(13%),各种真菌14例(22%)。而青壮年组的病原分布为:细菌47例(70%),病毒感染10例(15%),结核10例(15%)。老年组临床特点主要是基础疾病多、诱发因素多、住院时间长、合并用抗生素的情况显著多于青壮年组(P<0.05)。结论老年院内获得性肺炎的病原分布广,混合感染多,CT表现为肺实质及间质同时受累多,真菌肺感染是老年院内感染的特点之一。Objective To explore the clinical and image characteristics of hospital acquired pneumonia （HAP） in the elderly. Methods The medical data were reviewed for 67 cases of confirmed HAPs in the elderly, compared with the HAPs of 67 young adults. Their clinical and etiological characteristics were studied. Results The pathogens in the elderly included bacteria （31 cases, 46% ）, Chlamydia or Mycoplasma （6 cases, 9% ）, virus（7 cases, 10% ）, tuberculosis （9 cases, 13% ）, and fungi （14 cases, 22% ）. In the HAPs of young adults, the pathogens included bacteria （47, 70% ）, virus （10, 15% ）, and tuberculosis （10, 15% ）. The HAP in the elderly had more underlying diseases, more causative factors and longer in-hospital stay time, and more antibiotics used than those in the young adults （ P 〈 0.05 ）. Conclusion Wide-spread pathogens included fungi, much polyinfection, and CT features showed lung parenchyma mesenchymal simultaneously as the clinical characteristics of HAPs in the elderly. The clinical features and pathogens of HAP are different between the elderly and young aduhs. It is very important to understand the characteristics of HAP in the elderly in order to improve their outcome.

关 键 词：老年 院内获得性肺炎 CT 真菌感染 

分 类 号：R563.1[医药卫生—呼吸系统]