摘要
目的探讨住院老年人社区获得性肺炎（CAP）的危险因素,为预防老年人CAP提供临床参考。方法采用配对病例对照研究,将患者分为CAP组和对照组,进行问卷调查基础疾病和生活质量,检查和评价营养状态。采用条件Logistic回归进行住院老年人CAP的危险因素分析。结果入选病例138例,男性90例（65%）,女性48例（35%）。CAP组69例,年龄61～94岁,平均（74.5±6.9）岁;对照组69例,年龄60～89岁,平均（73.6±6.9）岁。单因素分析结果提示,曾经吸烟（OR=5.71）、目前正在吸烟（OR=18.26）、慢性支气管炎（OR=3.75）、既往肺结核病史（OR=2.67）、入选前1年内因肺炎住院史（OR=14.93）、入选前1～2年因肺炎住院史（OR=5.99）、营养状况中等（OR=5.11）、营养状况较差（OR=11.55）、体质指数（OR=0.81）、血清白蛋白水平（OR=0.14）、外周血淋巴细胞计数（OR=0.50）、日常生活能力量表（ADL）评分（OR=0.46）、轻度体育活动（OR= 0.24）、中度体育活动（OR=0.04）、进餐时间长短（OR=1.11）为老年人CAP的危险因素（均为P〈0.05）。多因素回归分析显示,ADL评分（OR=0.34）、曾经吸烟（OR=15.98）、目前正在吸烟（OR= 73.85）、慢性支气管炎病史（OR=22.88）、体质指数（OR=0.76）、入选前1年内因肺炎住院史（OR= 55.56）、入选前1～2年因肺炎住院史（OR=30.30）是老年人CAP的独立危险因素,差异均有统计学意义（均为P〈0.05）。结论吸烟、慢性支气管炎、肺炎住院史、营养不良是老年人易患肺炎的危险因素。
Objective To identify the risk factors for community-acquired pneumonia （CAP） in the elderly. Methods A case-control study of risk factors for CAP in elderly was performed. Sixtynine patients with community-acquired pneumonia （case group） admitted to hospital were studied with control group（n=69） matched for sex, age and duration of admission. The two groups were compared with regard to risk factors for CAP using a questionnaire. Results Male was 90（650%）, female was 48（350%）. Mean age was （74.5±6.9）years （ranged from 61 to 94 years） in patients with CAP, and （73.6±6.9） years （ranged from 60 to 89 years） in control subjects. In univariate analysis, ex-smoker （OR=5.71）, current-smoker（OR= 18.26）, chronic bronchitis（OR = 3. 75）, history of tuberculosis （OR=2.67）, history of pneumonia 〈1 year prior to enrollment （OR=14.93）, history of pneumonia within 2 years and till 1 year of enrollment（OR = 5.99）, moderate nutrition status （OR = 5.11）, malnutrition（OR= 11.55 ）, BMI （OR = 0.81 ）, serum Alb （OR = 0.14 ）, lymphocyte account （OR = 0.50）, activities of daily living scale （ADL） （OR = 0.46）, light physical exercise （OR = 0.24）, moderate physical exercise（OR = 0.04） and swallowing difficult（OR= 1.11） were risk factors for CAP in elderly （P 〈 0.05） . Conditional logistic regression analysis showed that ADL （OR = 0.34）, ex-smoker（OR = 15.98）, current-smoker （OR = 73.85）, chronic bronchitis （OR = 22.88）, BMI （OR=0.76）, history of pneumonia 〈1 year prior to enrollment（OR= 55.56） ,history of pneumonia within 2 years and till 1 year of enrollment （OR=30.30） were independent risk factors for CAP in the elderly（all P〈0. 05）. Conclusions Cigarette smoking, chronic lung diseases, malnutrition are risk factors for community-acquired pneumonia. Cigarette smoking is the most adaptable factor.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2007年第12期918-921,共4页
Chinese Journal of Geriatrics
基金
国家十五科技攻关课题（2001BA702B05）
关键词
社区获得性感染
肺炎
危险因素
Community-acquired infection
Pneumonia
Risk factors
