实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (1): 78-82.doi: 10.3969/j.issn.1003-9198.2025.01.018

• 临床研究 • 上一篇    下一篇

老年特发性间质性肺炎继发肺部感染的危险因素及预测模型建立

肖琼, 胡泽福, 邓安彬, 余丽华, 祝天松, 温茜, 张琴   

  1. 635000 四川省达州市,达州市达川区人民医院(达州市第三人民医院)呼吸与危重症医学科
  • 收稿日期:2024-03-28 出版日期:2025-01-20 发布日期:2025-01-15
  • 通讯作者: 张琴,Email:15528885225@163.com

Risk factors and prediction model of secondary pulmonary infection in elderly patients with idiopathic interstitial pneumonia

XIAO Qiong, HU Zefu, DENG Anbin, YU Lihua, ZHU Tiansong, WEN Xi, ZHANG Qin   

  1. Department of Respiratory and Critical Care Medicine, Dazhou Dachuan District People’s Hospital (Dazhou Third People’s Hospital), Dazhou 635000, China
  • Received:2024-03-28 Online:2025-01-20 Published:2025-01-15
  • Contact: ZHANG Qin, Email: 15528885225@163.com

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摘要： 目的 探讨老年特发性间质性肺炎(IIP)病人继发肺部感染(PI)的危险因素,并建立预测模型。方法 选取2020年1月至2024年1月于达州市达川区人民医院住院治疗的老年IIP病人248例,根据住院期间是否继发PI分为IIP组和IIP-PI组。通过多因素Logistic回归分析老年IIP病人继发PI的危险因素,并构建预测模型。采用ROC曲线分析预测模型对老年IIP病人继发PI的评估价值。结果 248例老年IIP病人中75例(30.24%)发生PI,纳入IIP-PI组,其余173例纳入IIP组。IIP-PI组年龄、病程、白细胞计数、CRP、合并糖尿病、预防性应用抗生素、日均激素使用量≥30 mg比例大于IIP组,白蛋白水平低于IIP组(P＜0.05)。多因素Logistic回归分析显示,年龄、合并糖尿病、预防性应用抗生素、病程、日均激素使用量、白细胞计数、CRP均是IIP继发PI的独立危险因素,白蛋白是其独立保护因素(P＜0.05)。ROC曲线结果显示,该多因素Logistic回归模型预测IIP继发PI的AUC为0.929(95%CI:0.889～0.958)。结论 年龄、合并糖尿病、预防性应用抗生素、病程、日均激素使用量、白细胞计数、CRP、白蛋白是老年IIP继发PI的影响因素,根据以上因素构建的风险预测模型可作为继发PI的重要预测工具。

关键词: 特发性间质性肺炎, 肺部感染, 危险因素, 预测模型

Abstract: Objective To investigate the risk factors of secondary pulmonary infection (PI) in the elderly patients with idiopathic interstitial pneumonia (IIP), and to establish a predictive model. Methods A total of 248 patients with IIP treated in Dazhou Dachuan District People’s Hospital from January 2020 to January 2024 were selected and divided into IIP group and IIP-PI group according to whether they presented with secondary PI during hospitalization. The influencing factors of secondary PI in IIP patients were analyzed by multiple Logistic regression, and the prediction model was constructed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the prediction model for secondary PI in the elderly patients with IIP. Results Among 248 patients with IIP, 75 cases (30.24%) presented with PI. The age, disease course, the levels of white blood cell count and C-reactive protein (CRP), and the proportion of combined diabetes mellitus, prophylactic antibiotics and daily hormone use ≥30 mg in IIP-PI group were higher than those in IIP group, and the level of albumin was lower than that in IIP group (P<0.05). Multivariate Logistic regression analysis showed that age, combined diabetes, prophylactic use of antibiotics, course of disease, daily dose of hormone, white blood cell count and CRP were independent risk factors for secondary PI, and albumin was an independent protective factor (P<0.05). The AUC of Logistic regression model for predicting PI secondary to IIP was 0.929 (95%CI: 0.889－0.958). Conclusions Age, combined diabetes, prophylactic antibiotic use, course of disease, daily hormone use, white blood cell count, CRP and albumin are the influential factors for secondary PI in the elderly patients with IIP. The risk prediction model based on the above factors can be used as an important tool for secondary PI.

Key words: idiopathic interstitial pneumonia, lung infection, risk factor, prediction model

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