Comparation of clinical characteristics of elderly and non-elderly community acquired pneumonia patients
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摘要:
目的 探讨老年与非老年社区获得性肺炎(CAP)患者的临床特点。 方法 检索我院2014年4月~2017年4月呼吸内科电子病历系统,纳入CAP患者292例,比较其一般项目、住院时间、入院时患者首发症状、痰培养结果、抗生素应用情况、临床及实验室资料。 结果 292例CAP患者,年龄14~89岁(49.10±19.4岁),住院时间9.11±3.23 d,细菌培养率为11.64%,老年组与非老年组患者的基础合并症、痰培养、中性粒细胞数、降钙素原、红细胞沉降率差异有统计学意义(P<0.05),两组患者的住院时间、C反应蛋白、入院症状差异无统计学意义(P>0.05)。老年组患者与非老年组患者的B类酰胺类、喹诺酮类、大环内酯类使用差异无统计学意义,林可酰胺类使用差异有统计学意义(P<0.05)。 结论 老年组CAP患者常合并各种基础疾病,老年组患者的降钙素原敏感度、痰培养阳性率高于非老年组患者,病原体检出阳性率低。 Abstract:Objective To compare the clinical characteristics of elderly and non-elderly community-acquired pneumonia (CAP) patients. Methods A total of 292 cases of CAP hospitalized in the Affiliated Hospital of Guilin Medical University from April 2014 to April 2017 were included. Their medical readings logged into the electronic medical record system of the department of respiratory medicine were collected, among which those general items, including length of hospital stay, initial symptoms at admission, sputum culture result, antibiotic use, clinical and laboratory data, were statistically analyzed via clinical epidemiological investigation methods. Results The age range, average age, average hospitalization time and bacterial culture rate of these 292 CAP cases were 14-89 years old, (49.10±19.4) years old, (9.11±3.23) d, and 11.64% respectively. The differences of the underlying comorbidity, sputum culture, NEUT, PCT and ESR between two groups were significant(P<0.05),while no significant differences were found in length of hospital stay, CRP, and initial symptoms at admission. No significant differences were found in the use of B amides, quinolones and macrolides between two groups, while the use of forest amides differed significantly between two groups. Conclusion CAP patients in the elderly group tend to be complicated with underlying diseases. The PCT sensitivity and positive rate of sputum culture in the elderly group were higher than that in the non-elderly group, while the positive rate of pathogen detection in the elderly group was lower than that in the non-elderly group. -
Key words:
- community-acquired pneumonia /
- age /
- pathogenic bacteria
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表 1 老年组与非老年组一般情况对比
指标 非老年组(<60岁,n=190) 老年组(≥60岁,n=102) P 住院时间M(P25,P75) 9(7,11) 8.5(7,10) 0.634 有基础疾病(n=118) 51(43.2%) 67(56.8%) 0.000 入院症状 咳嗽(n=125) 85(68.0%) 40(32.0%) 0.514 发热(n=54) 36(66.7%) 18(33.3%) 均有(n=113) 69(61.1%) 44(38.9%) 痰培养 阳性(n=34) 16(47.1%) 18(52.9%) 0.019 WBC(×109) 阳性(n=68) 51(75.0%) 17(25.0%) 0.040 NEUT(%) 阳性(n=125) 85(68.0%) 40(32.0%) 0.030 CRP(mg/L) 阳性(n=168) 111(66.0%) 57(44.0%) 0.067 PCT(ug/L) 阳性(n=106) 47(44.3%) 59(55.7%) 0.000 ESR(mm/H) 阳性(n=214) 139(65.0%) 75(35.0%) 0.940 M(P25, P75)=四分位数间距; WBC: 白细胞; NEUT: 中性粒细胞数; CRP: C反应蛋白; PCT: 降钙素原; ESR: 红细胞沉降率. 表 2 老年组与非老年组抗生素使用情况对比
抗生素 非老年组(<60岁,n=190) 老年组(≥60岁,n=102) P B类酰胺类M(P25,P75) 8(6,10) 8(6,10) 0.931 喹诺酮类M(P25,P75) 0(0,6) 0(0,5) 0.533 大环内酯类M(P25,P75) 0(0,4) 0(0,4) 0.462 林可酰胺类 无(n=256) 161(62.9%) 95(37.1%) 0.037 有(n=36) 29(80.6%) 7(19.4%) M(P25, P75): 四分位数间距. -
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