老年冠心病患者急性下呼吸道感染初期炎症、营养代谢指标与近期预后的关系  

Relationship of prognosis with initial inflammation and nutrition indexes in the elderly patients with stable coronary artery disease suffering from acute lower respiratory tract infection

作　　者：赵晓茜[1] 杜瑞雪[1] 肖铁卉[1] 郑瑾[1] 朱兵[1] 骆雷鸣[1] 

机构地区：[1]中国人民解放军总医院老年心血管科,北京市100853

出　　处：《实用老年医学》2015年第7期545-548,共4页Practical Geriatrics

基　　金：军队保健专项科研课题(2012-12BJZ34)

摘　　要：目的探讨老年冠心病患者急性下呼吸道感染初期炎症及营养代谢指标变化,以及对近期全因死亡的影响。方法 426例老年稳定型冠心病患者,根据是否合并急性下呼吸道感染分为感染组和非感染组。随访感染后90 d内全因死亡的发生情况及炎症、营养代谢指标的变化,探讨相关危险因素。结果 90 d随访结果显示,426例研究对象中死亡37例,死亡率为8.7%。感染组死亡率显著高于非感染组(13.2%比1.8%,P<0.01)。90 d死亡的多因素回归分析显示,急性下呼吸道感染、血浆尿素氮和前白蛋白是90 d全因死亡的独立危险因素(P<0.05)。结论急性下呼吸道感染、血浆尿素氮和前白蛋白水平能够独立预测感染后近期全因死亡的风险,积极预防感染和纠正营养代谢障碍可能有益于改善预后。Objective To investigate the levels of serum inflammatory factors,nutritional and metabolic markers at the early stage of acute lower respiratory tract infection（ ALRTI） in the elderly patients with stable coronary artery disease（ s CAD）,and to investigate the effects of all-cause mortality rate during 90 days. Methods 426 elderly patients with s CAD were divided into 2 groups according to whether suffering from ALRTI or not. They were follow-up for all-cause mortality in the following 90 days. The relationship between inflammatory,nutritional and metabolic makers with 90 days allcause death was analyzed and evaluated. Results During 90 days＇ follow-up in 426 participants,37 cases（ 8. 7%）died,and the all-cause mortality rate in infection group was significantly higher than that in no infection group（ 13. 2% vs1. 8%,P 0. 01）. Multivariate analysis showed that ALRTI（ OR = 3. 531,95% CI： 1. 017-12. 258,P = 0. 047）,BUN（ OR = 1. 113,95% CI： 1. 026-1. 207,P = 0. 010） and PA（ OR = 0. 920,95% CI： 0. 860-0. 984,P = 0. 016） were independent risk factors for early all cause death after ALRTI in the elderly patients with s CAD. Conclusions ALRTI,plasma BUN and PA are risk factors of short-term mortality in the elderly patients with s CAD. It will be very important to prevent infection and improve malnutrition for the outcome of the elderly with s CAD.

关 键 词：急性下呼吸道感染 营养及代谢指标 全因死亡 

分 类 号：R541.4[医药卫生—心血管疾病]