老年、高龄老年和超高龄老年社区获得性肺炎的临床特征及预后对照分析  

Comparisons of clinical characteristics and prognosis in elderly,oldest-old,and super elderly patients with community acquired pneumonia

作　　者：李音[1] 姜红妮[2] 瞿介明[3] 

机构地区：[1]复旦大学附属华东医院急诊科,上海市200040 [2]复旦大学附属中山医院呼吸科,上海市200032 [3]交通大学医学院附属瑞金医院呼吸科,上海市200025

出　　处：《老年医学与保健》2016年第1期19-23,共5页Geriatrics & Health Care

摘　　要：目的比较不同年龄段的老年社区获得性肺炎患者的临床特征及预后,为临床诊治提供参考。方法回顾性分析2012年8月-2013年7月于复旦大学附属华东医院就诊的92例老年社区获得性肺炎(community acquired pneumonia,CAP)患者的临床资料,按年龄分为老年组、高龄组及超高龄组,比较不同年龄段的老年社区获得性肺炎患者的临床特征及预后。结果与老年组相比,超高龄组发热率下降,更易出现呼吸困难;但咳嗽、咳痰发生率在3组间差异无统计学意义。3组患者起病时WBC、CRP、PCT异常率差异无统计学意义;与老年组相比,超高龄组更易出现CO_2潴留和低氧血症。胸腔积液发生率和病灶分布情况在3组间差异无统计学意义。与老年组相比,超高龄组肺部阴影吸收时间延长,使用抗生素时间延长,住院费用增加。超高龄组住院时间长于老年组及高龄组。结论随年龄的升高,老年人CAP发热率下降,呼吸困难表现增多,更易出现CO_2潴留和低氧血症。Objective To compare the clinical features and prognosis between different age groups of elderly community acquired pneumonia patients to assist clinical diagnosis and treatment. Methods A retrospective analysis was carried out on the clinical data of 92 elderly patients of community-acquired pneumonia from August 2012 to July 2013 to compare the clinical features and prognosis between different age groups of elderly community acquired pneumonia patients. Results Our research showed that fever was more prone to be absent in super elderly group than in elderly group, but dyspnea, hyper- capnia and hypoxia, were more common in the super elderly group than in elderly group. The incidence rate of cough, sputum and abnormal WBC, CRP, PCT were similar among three groups. The incidence of pleural effusion and the distribution of lesions was also similar among three groups. Outcome of initial antibiotic treatment was similar in three groups but the resolution period of image abnormalities was longer in super elderly group than that in the elderly group. Meanwhile, compared with the elderly group, the hospital stay, the use of antibiotics, and the cost of hospitalization were higher in the super elderly group. Conclusion This study demonstrated that with aging, the elderly CAP patients are more common with low rate of fever, high rate of dyspnea, hypercapnia and hypoxia.

关 键 词：社区获得性肺炎 老年 高龄 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]