132例60岁以上老年危重症流感临床特征及危险因素分析  

Analysis of Clinical Characteristics and Risk Factors of 132Critically Ill Influenza over 60Year Old Patients

作　　者：李圆菲 曹理言 谢和宾 王光宇 朱改开 刘希良[2] LI Yuan-fei;CAO Li-yan;XIE He-bin;无(The Affiliated Changsha Central Hospital,University of South China,Changsha 410004,China;Changsha College,Changsha 410004,China)

机构地区：[1]南华大学附属长沙中心医院,湖南长沙410004 [2]长沙学院,湖南长沙410004

出　　处：《中国实验诊断学》2022年第6期846-850,共5页Chinese Journal of Laboratory Diagnosis

基　　金：湖南省自然科学基金项目(2020JJ8044);2021年湖南省教育厅科学研究重点项目(21A0539);长沙市中心医院立项课题(YNKY201915)。

摘　　要：目的探讨60岁以上老年流感患者临床特征,分析进展为危重症流感患者危险因素,为临床早期识别高风险人群和干预提供依据。方法回顾性分析2018年1月-2019年12月283例60岁以上流感老人的临床资料,根据临床表现分为危重症组、非危重症组两组,分析其临床特征。结果在纳入研究的流感老年患者中,危重症组132例,非危重症组151例。危重症组男性明显多于女性,住院时间明显延长,患冠心病、COPD、肺结核病患者明显多于非危重症组(P<0.05)。危重症组咳嗽、气促比例,合并心力衰竭、肾功能不全、肺炎比例明显高于非危重症组(P<0.05)。实验室检查危重症组痰细菌、真菌培养、血培养阳性比例明显高于非危重症组;中性粒细胞比例、BNP明显高于非危重症组,淋巴细胞数比例、降钙素原明显低于非危重症组(P<0.05)。死亡率明显高于非危重症组(P<0.05)。Logistic回归分析显示咳嗽、气促症状,中性粒细胞百分比高,入住ICU、基础病COPD为流感患者进展为危重症患者独立危险因素(P<0.05)。结论临床表现为咳嗽、气促,中性粒细胞百分比高,基础病合并COPD感染,入住ICU老年流感患者容易进展为危重症患者。Objective To explore the clinical characteristics of influenza patients over 60years old,analyze the progress of risk factors for critically ill influenza patients,and provide evidence for early clinical identification of high-risk groups and intervention.Methods A retrospective analysis of the clinical data of 283elderly people with influenza over60years old from January 2018to December 2019was divided into two groups:critically ill group and non-critically ill group according to their clinical manifestations,and their clinical characteristics were analyzed.Results Among the elderly patients with influenza included in the study,132were in the critically ill group and 151were in the non-critically ill group.Compared to the critically ill group and the non-critically ill group,There were significantly more men in the critically ill group than women,and the length of hospital stay was significantly longer.There were significantly more patients suffering from coronary heart disease,COPD,and tuberculosis than in the non-critically ill group(P<0.05).The proportion of cough,shortness of breath,heart failure,renal insufficiency,and pneumonia in the critically ill group was significantly higher than that in the non-critically ill group(P<0.05).In laboratory tests,the positive rate of sputum bacteria,fungal culture,and blood culture in the critically ill group was significantly higher than that of the non-critically ill group;the ratio of neutrophils and BNP was significantly higher than that of the non-critically ill group,and the ratio of lymphocyte count and procalcitonin were significantly lower In the non-critically ill group(P<0.05).The mortality rate of was significantly higher than that of the non-critically ill group(P<0.05).Logistic regression analysis showed that symptoms of cough,shortness of breath,high percentage of neutrophils,admission to the ICU,and the underlying disease COPD were independent risk factors for influenza patients to progress to critically ill patients(P<0.05).Conclusion The clinical manife

关 键 词：老年 危重症 流行性感冒 临床特征 危险因素 

分 类 号：R373.1[医药卫生—病原生物学]