老年呼吸道感染9项常见病原体分布特点及危险因素分析  

Analysis of distribution characteristics and risk factors of 9 common pathogens of respiratory tract infection in elderly patients

作　　者：王一律 钟文[1] 王真[1] 张晓娟 陈睿 Wang Yilv;Zhong Wen;Wang Zhen;Zhang Xiaojuan;Chen Rui(Department of General Medicine,Third People's Hospital of Chengdu City,Chengdu,Sichuan,610014,P.R.China)

机构地区：[1]成都市第三人民医院全科医学科,四川成都610014

出　　处：《老年医学与保健》2024年第3期730-733,738,共5页Geriatrics & Health Care

基　　金：2021年成都市医学科研课题(2021221)。

摘　　要：目的了解老年呼吸道感染(RTI)9项常见病原体的分布情况及老年RTI危险因素,为临床降低感染发生率及合理用药提供依据。方法选取2021年1月—2023年9月于成都市第三人民医院收治的接受9项常见呼吸道病原体IgM抗体检测的老年RTI患者395例,分析其病原体检出及分布特点,另按1∶1的比例选取同期住院部收治的未出现RTI老年患者395例为对照组,使用多因素Logistic回归分析老年RTI的影响因素。结果9项常见呼吸道病原体IgM抗体阳性率为12.91%(51/395),其中肺炎支原体(MP)IgM抗体阳性率6.08%(24/395);病原体IgM抗体阳性率在四季中差异无统计学意义(P>0.05);肺炎、支气管肺炎患者的MP的IgM抗体阳性率、病原体IgM抗体总阳性率均高于急性上呼吸道感染、急性支气管肺炎、喘息性支气管肺炎患者(P<0.05);年龄≥75岁人群MP IgM阳性率、病原体IgM抗体总阳性率均高于60~74岁人群(P<0.05)。多因素Logistic回归分析显示,抗生素≥2种、使用免疫抑制剂、基础疾病≥3种是老年RTI的独立危险因素(P<0.05)。结论老年患者RTI病原体可能以MP为主,多见于肺炎、支气管肺炎,多发于年龄≥75岁年龄段,有使用抗生素、免疫抑制剂和合并多种基础疾病可增加老年RTI风险。Objective To understand the distribution of 9 common pathogens and risk factors for respiratory tract infections(RTI)in elderly patients,and provide a basis for reducing the incidence of infections and rational medication in clinical practice.Methods A total of 395 elderly patients with RTI who underwent IgM antibody detection of 9 common pathogens in Third People's Hospital of Chengdu City from January 2021 to September 2023 were enrolled.The detection rate and distribution characteristics of pathogens were analyzed.In addition,a total of 395 elderly patients without RTI admitted to Inpatient Department during the same period were selected as the control group at a ratio of 1∶1.Multivariate logistic regression was used to analyze the influencing factors of RTI in elderly patients.Results The positive rate of IgM antibody of 9 common respiratory pathogens was 12.91%(51/395),and positive rate of IgM antibody against Mycoplasma pneumoniae(MP)was 6.08%(24/395).There was no statistically significant difference in the positivity rate of pathogen IgM antibodies among the four seasons(P>0.05).The positive rate of IgM antibody against MP and total positive rate of pathogen IgM antibody in patients with pneumonia and bronchopneumonia were higher than those in patients with acute upper respiratory tract infection,acute bronchopneumonia and asthmatic bronchopneumonia(P<0.05).The positive rate of IgM antibody against MP and total positive rate of pathogen IgM antibody in patients aged≥75 years were higher than those in patients aged 60-74 years(P<0.05).Multivariate logistic regression analysis showed that antibiotic types≥2,use of immunosuppressants and underlying diseases≥3 were independent risk factors of RTI(P<0.05).Conclusion MP is one of the main pathogens in elderly patients with RTI,which is more common in those with pneumonia and bronchopneumonia and age of≥75 years.The use of antibiotics and immunosuppressants,and multiple underlying diseases will increase RTI risk in elderly patients.

关 键 词：老年 呼吸道感染 病原体 影响因素 

分 类 号：R446.5[医药卫生—诊断学]