362例社区获得性肺炎患者临床特征及影响因素分析

发布时间：2018-06-21 04:01

本文选题：社区获得性肺炎 + 临床特征　；参考：《南京医科大学学报(自然科学版)》2014年06期

【摘要】：目的:分析南京医科大学第二附属医院呼吸科社区获得性肺炎(community-acquired pneumonia,CAP)住院患者的临床、病原学和转归特点,以及相关的影响因素。方法:回顾性分析CAP住院患者的临床资料,比较其年龄、吸烟情况、基础疾病、病原学特点、临床用药情况等;并分析易感CAP的危险因素。结果:362例CAP患者平均年龄为(69.3±17.2)岁。位居前5位的基础疾病分别是高血压164例(45.3%)、慢性阻塞性肺疾病151例(41.7%)、心功能不全81例(22.4%)、糖尿病79例(21.8%)、冠心病72例(19.9%)。177例(48.9%)治愈,168例(46.4%)好转,17例(4.7%)未愈或死亡。362例中312例进行了病原体检测,仅100例查到了病原体,其中前5位的病原体分别是白假丝酵母菌31例,革兰氏阴性菌11例,鲍曼不动杆菌和肺炎克雷伯菌各8例,铜绿假单胞菌7例。Logistic回归分析显示:高龄(β=0.180,P=0.001)、中性粒细胞百分比高(β=0.127,P=0.035)、前白蛋白低(β=0.140,P=0.024)、合并肺心病(β=7.851,P=0.046)、合并脑梗死(β=4.861,P=0.029)是CAP转归不良的危险因素。结论:南京医科大学第二附属医院呼吸科CAP患者以老年人为主。患者大量合并各种基础疾病,以高血压、慢性阻塞性肺疾病、糖尿病、心功能不全、冠心病最常见,且年龄越大越容易合并基础疾病。病原体检出阳性率低。高龄、中性粒细胞百分比高、前白蛋白低、合并肺心病、合并脑梗死是转归不良的危险因素。
[Abstract]:Objective: to analyze the clinical features, etiology and outcome of community-acquired pneumonia (CAP) inpatients with community-acquired pneumonia (CPAP) in the second affiliated Hospital of Nanjing Medical University. Methods: the clinical data of the hospitalized patients with CAP were analyzed retrospectively, the age, smoking status, basic diseases, etiological characteristics and clinical medication were compared, and the risk factors of CAP were analyzed. Results the average age of 362 CAP patients was 69.3 卤17.2 years old. The top 5 basic diseases were hypertension 164 cases (45.3%), chronic obstructive pulmonary disease 151 cases (41.7%), cardiac insufficiency 81 cases (22.441%), diabetes mellitus (79 cases) 21.8T, coronary heart disease (72 cases) 19.9G (177 cases 48.9), cure 168 cases (46.4%) improvement and death in 17 cases (4.72 cases). 312 cases were tested for pathogens, Only 100 pathogens were detected, among which 31 were Candida albicans, 11 were Gram-negative bacteria, 8 were Acinetobacter baumannii and 8 Klebsiella pneumoniae, respectively. Logistic regression analysis of 7 cases of Pseudomonas aeruginosa showed that old age (尾 -0.180), high percentage of neutrophils (尾 -0.127), prealbumin (尾 -0.140), cor pulmonale (尾 -7.851P 0.04646) and cerebral infarction (尾 4.861P ~ (0.029) were the risk factors for the adverse outcome of CAP. Conclusion: the elderly are the main CAP patients in the respiratory department of the second affiliated Hospital of Nanjing Medical University. A large number of patients associated with a variety of basic diseases, hypertension, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease is the most common, and the older the more easily associated with basic diseases. The positive rate of pathogens was low. Old age, high percentage of neutrophils, low prealbumin, combined with cor pulmonale and cerebral infarction are risk factors for adverse outcome.
【作者单位】：南京医科大学第二附属医院呼吸科;
【基金】：江苏省六大人才高峰项目(WSN-206-123)
【分类号】：R563.1

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