老年社区获得性肺炎预后预测指标研究新进展  

New progress in the study of prognostic predictors of community acquired pneumonia in the elderly

作　　者：曹洋 王翔宇[1] CAO Yang;WANG Xiangyu(Department of Respiratory and Critical Care Medicine,Third Clinical Medical College of Three Gorges University,Yichang,Hubei 443002,China)

机构地区：[1]三峡大学第三临床医学院呼吸与危重症医学科,湖北宜昌443002

出　　处：《医药前沿》2023年第23期64-68,共5页Journal of Frontiers of Medicine

摘　　要：社区获得性肺炎(CAP)是指在医院外罹患的感染性肺实质炎症,包括具有明确潜伏期的病原体感染,在入院后于潜伏期内发病的肺炎,常见病原体包括细菌、病毒、真菌等。老年患者常因为免疫力低下和众多基础疾病,易在感染CAP后出现各种并发症,因此其对老年人的危害比对年轻人更大。全球疾病负担研究表明,CAP是超65岁老人医院就诊的第三大诊断,同时也是超65岁老年患者的死亡主因之一。同时在老年CAP患者中,其临床表现中肺外表现(谵妄、跌倒恶化或慢性精神错乱)往往比肺部表现(咳痰、咳痰、发热或呼吸困难)更常见,更容易延误对CAP的及时识别和干预,寻找有效的预测指标对了解老年CAP患者病情、预测预后及降低病死率有重要意义。通过不断寻找有效的生物标志物和系统评分量表,可以更准确地评估老年CAP患者的病情,有助于提高诊断准确性、判断病情严重程度、监测疗效并指导后续治疗决策,从而达到合理使用抗生素、预防并发症和降低患者病死率的目的,这对于临床实践和研究都具有重要意义。本文采用正五聚蛋白3、IL-27、CPR/ALB、衰弱评估量表、CURB(S)-65评分表等对老年CAP的预测效能或预测潜力进行探索。Community acquired pneumonia(CAP)is defined as infectious inflammation of the lung parenchyma that occurs outside the hospital,including pathogen infection with a clear incubation period,and pneumonia that develops within the incubation period after admission to the hospital,and the common pathogens include bacteria,viruses,fungi,etc.The elderly patients often have low immunity because of their low immunity.Elderly patients are often susceptible to various complications of CAP infection due to their low immunity and numerous underlying diseases,making it more harmful to the elderly than to the young.The Global Burden of Disease study shows that CAP is the third most common diagnosis for hospital visits in people over 65 years of age,and it is also one of the leading causes of death in elderly patients over 65 years of age.Meanwhile,in elderly patients with CAP,extrapulmonary manifestations(delirium,worsening of falls or chronic psychosis)tend to be more common than pulmonary manifestations(sputum,cough,fever or dyspnea)in their clinical presentations,which makes us prone to delaying the timely recognition and intervention of CAP,and it is important to search for validated predictive indicators to help us to understand the condition of elderly patients with CAP,to predict the prognosis and to reduce the mortality rate.In this study,we explored the predictive efficacy or predictive potential of CAP in the elderly using pentraxin 3,IL-27,CPR/ALB,Frailty Assessment Scale,and CURB(S)-65 rating scale.Aims for the study of prognostic predictors of CAP in the elderly,in addition to the joint use of the original indicators other reasons for the impact.

关 键 词：综述 社区获得性肺炎 老年人 PTX3 IL-27 CRP/ALB 衰弱量表 

分 类 号：R563.1[医药卫生—呼吸系统]