阿尔茨海默病痴呆患者发生难治性肺炎的危险因素分析  

The risk factors of refractory pneumonia in patients with Alzheimer′s dementia

作　　者：田蓉[1] 吕继辉[1] 李桂英[1] 周薇[1] 苏斯佳 李倩倩 TIAN Rong;LYU Jihui;LI Guiying;ZHOU Wei;SU Sijia;LI Qianqian(Department of Respiratory,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院呼吸科,北京100095

出　　处：《中国临床保健杂志》2025年第1期54-57,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨阿尔茨海默病痴呆患者发生难治性肺炎的危险因素,为临床干预提供依据。方法回顾性分析2023年6月至2024年5月在北京老年医院住院治疗的95例阿尔茨海默病痴呆合并社区获得性肺炎患者的一般资料和肺炎相关特征、检查检验资料。利用多因素logistic回归分析阿尔茨海默病痴呆患者发生难治性肺炎的危险因素。结果阿尔茨海默病痴呆患者难治性肺炎组放置胃肠管、咳嗽反射消失、呼吸衰竭、心功能不全、CURB-65评分、坠积性肺炎表现、大量胸腔积液、白细胞介素-6、降钙素原、B型脑钠肽等均高于非难治性肺炎组(均P<0.05),血淋巴细胞计数、血清前白蛋白和白蛋白低于非难治性肺炎组(均P<0.05)。多因素logistic回归分析提示,血清前白蛋白降低(OR=0.979,95%CI:0.962~0.997,P=0.023)、心功能不全(OR=7.779,95%CI:1.101~54.982,P=0.040)、大量胸腔积液(OR=14.223,95%CI:1.783~113.436,P=0.012)的阿尔茨海默病痴呆患者更易发生难治性肺炎。结论血清前白蛋白降低、并发心功能不全、大量胸腔积液是阿尔茨海默病痴呆患者发生难治性肺炎的危险因素。Objective To explore the risk factors of refractory pneumonia in patients with Alzheimer′s dementia,providing a basis for clinical intervention.Methods A retrospective analysis was conducted on the general data,pneumonia-related characteristics,and examination and test data of 95 Alzheimer′s dementia patients with community-acquired pneumonia who were hospitalized in Beijing Geriatric Hospital from June 2023 to May 2024.Multivariate logistic regression analysis was used to identify the risk factors for refractory pneumonia in Alzheimer′s dementia patients.Results The refractory pneumonia group in Alzheimer′s dementia had higher rates of gastrointestinal tube placement,absence of cough reflex,respiratory failure,cardiac insufficiency,CURB-65 score,signs of atelectasis,large pleural effusion,interleukin-6,procalcitonin,and B-type natriuretic peptide compared to the non-refractory pneumonia group(P<0.05).Blood lymphocyte count,serum prealbumin,and albumin were lower in the refractory pneumonia group than those in the non-refractory pneumonia group(P<0.05).Multivariate logistic regression analysis indicated that Alzheimer′s disease dementia patients with reduced serum prealbumin(OR=0.979,95%CI:0.962-0.997,P=0.023),history of cardiac insufficiency(OR=7.779,95%CI:1.101-54.982,P=0.040),and large pleural effusion(OR=14.223,95%CI:1.783-113.436,P=0.012)were more likely to develop refractory pneumonia.Conclusion Reduced serum prealbumin,concurrent cardiac insufficiency,and large pleural effusion are risk factors for refractory pneumonia in Alzheimer′s dementia patients.

关 键 词：阿尔茨海默病 肺炎 危险因素 

分 类 号：R74[医药卫生—神经病学与精神病学]