老年社区获得性肺炎病原学特点及发病危险因素分析  

Analysis of the etiological characteristics and risk factors of elderly patients with community-acquired pneumonia

作　　者：石佳星 马秀红 尹志洋 Shi Jiaxing;Ma Xiuhong;Yin Zhiyang(Beijing Huairou Hospital,Beijing 101400,China)

机构地区：[1]北京怀柔医院,北京101400

出　　处：《首都食品与医药》2025年第8期90-93,共4页Capital Food Medicine

摘　　要：目的结合临床实践经验,探讨老年社区获得性肺炎患者病原学特点及发病危险因素。方法选取2019年5月-2023年6月我院收治的老年社区获得性肺炎患者159例,对老年社区获得性肺炎患者病原学进行分析,包括检出病原学例数和构成比,对患者进行3个月随访,根据患者预后情况,分为预后良好组(106例)和预后不良组(53例),对不同预后患者的临床特征进行单因素分析,并对影响老年社区获得性肺炎患者预后影响因素进行Logistic回归分析。结果本次老年社区获得性肺炎159例患者中共检出病原体例数45例,主要有肺炎链球菌(13.33%)、肺炎克雷伯菌(11.11%)、流感嗜血杆菌(8.89%)、肺炎支原体(6.67%)、副流感病毒(6.67%)、乙型流感病毒(20.00%)等。经过3个月随访,预后良好患者106例,预后不良患者53例。预后良好组患者年龄、糖尿病、长期免疫抑制治疗、脓毒性休克、继发感染、行机械通气和预后不良组比较,有统计学差异(P<0.05),其余各指标两组无统计学差异(P>0.05)。经过Logistic回归分析,年龄≥70岁、糖尿病、长期免疫抑制治疗、脓毒性休克、继发感染和行机械通气均是影响老年社区获得性肺炎患者预后的危险因素(P<0.05)。结论应根据老年社区获得性肺炎患者病原学特点,对检出菌株比例较高的病原体加以重视,对年龄≥70岁、糖尿病、长期免疫抑制治疗、脓毒性休克、继发感染和行机械通气的患者应尤为注意,并采取相应干预措施,改善患者预后。Objective Based on clinical practice experience,explore the pathogenic characteristics and risk factors of elderly CAP patients.Methods A total of 159 elderly patients with community-acquired pneumonia admitted to our hospital from May 2019 to June 2023 were selected.The etiology of elderly patients with community-acquired pneumonia was analyzed,including the number of cases with detected etiology and the constituent ratio.The patients were followed up for 3 months.According to the prognosis of the patients,they were divided into a good-prognosis group(106 cases)and a poor-prognosis group(53 cases).Univariate analysis was performed on the clinical characteristics of patients with different prognoses,and logistic regression analysis was carried out on the influencing factors of the prognosis of elderly patients with community-acquired pneumonia.Results 45 cases of pathogens were detected from 159 cases of severe CAP in the elderly,the most common pathogens were Streptococcus pneumoniae(13.33%),Klebsiella pneumoniae(11.11%),Haemophilus influenzae(8.89%),Mycoplasma pneumoniae(6.67%),parainfluenza virus(6.67%)and influenza B virus(20.00%).After 3-month follow-up,106 patients with good prognosis,53 patients with poor prognosis.There were significant differences in age,diabetes,long-term immunosuppressive therapy,septic shock,secondary infection,mechanical ventilation and poor prognosis between the two groups(P<0.05),there was no significant difference in other indexes between the two groups(P>0.05).Through Logistics regression analysis,age≥70 years,diabetes mellitus,longterm immunosuppressive therapy,septic shock,secondary infection and mechanical ventilation were all risk factors affecting the prognosis of elderly patients with community-acquired pneumonia(P<0.05).Conclusion We should pay more attention to the high proportion of the detected strains according to the pathogenic characteristics of the aged patients with community-acquired pneumonia,special attention should be paid to age≥70 years,diabetes mellitus,

关 键 词：老年 社区获得性肺炎 病原学特点 发病危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]