贫血对老年社区获得性肺炎死亡的影响分析

doi:10.3969/j.issn.1003-9198.2024.03.011

实用老年医学 ›› 2024, Vol. 38 ›› Issue (3): 260-264.doi: 10.3969/j.issn.1003-9198.2024.03.011

贫血对老年社区获得性肺炎死亡的影响分析

彭泽通, 张尧, 刘斌

511400 广东省广州市,广州市番禺区中心医院康复医学科(彭泽通);511400 广东省广州市,广州市番禺区第二人民医院病案室(张尧);内科(刘斌)

收稿日期:2023-04-19 出版日期:2024-03-20 发布日期:2024-03-26
通讯作者: 张尧,Email:zy_research@126.com
基金资助:
广州市番禺区科技计划项目(2021-Z04-052)

Analysis of the effects of anemia on death in elderly patients with community-acquired pneumonia

PENG Zetong, ZHANG Yao, LIU Bin

Department of Rehabilitation Medicine,Guangzhou Panyu Central Hospital,Guangzhou 511400,China(PENG Zetong);Medical Records Room(ZHANG Yao);Department of Internal Medicine(LIU Bin),the Second People's Hospital of Panyu,Guangzhou 511400,China

Received:2023-04-19 Online:2024-03-20 Published:2024-03-26
Contact: ZHANG Yao,Email:zy_research@126.com

摘要/Abstract

摘要： 目的探讨合并贫血的老年社区获得性肺炎(CAP)病人临床特征以及贫血对预后的影响。方法选取2022年1—12月住院治疗的323例老年CAP病人为研究对象,依据贫血诊断标准,分为贫血组(n=151)和非贫血组(n=172),比较2组一般资料、实验室指标、治疗结局和肺炎严重程度。采用Logistic回归分析实验室指标和贫血对老年CAP病人预后的影响。结果贫血组凝血酶原时间、凝血酶时间、D-二聚体、尿素氮、中性粒细胞与淋巴细胞比值(NLR)、重症肺炎例数较非贫血组高,CRP、淋巴细胞、总蛋白、白蛋白、白/球蛋白比值、间接胆红素、丙氨酸氨基转移酶、肌酸激酶同工酶水平低于非贫血组,差异有统计学意义(P<0.05);2组间白细胞计数、降钙素原差异无统计学意义(P>0.05)。Logistic回归分析结果显示,贫血、CRP、D-二聚体、NLR、尿素氮、肌酐水平是老年CAP病人死亡的独立影响因素(P<0.05)。结论贫血是影响老年CAP病人预后的独立危险因素,在临床诊疗中应加强对血红蛋白水平的管理。

关键词: 肺炎, 老年人, 贫血, 预后, 临床特征

Abstract: Objective To investigate the clinical characteristics of the elderly patients with community-acquired pneumonia (CAP) combined with anemia and the impact of anemia on the prognosis of CAP. Methods A total of 323 elderly inpatients with CAP from January 2022 to December 2022 were selected as the research subjects. According to the diagnostic criteria for anemia, they were divided into anemia group (n=151) and non-anemia group (n=172). The general information, laboratory indicators, clinical outcomes and disease severity were recorded and compared between the two groups. Logistic regression was used to analyze the correlation of laboratory indicators or anemia with the prognosis of the elderly patients with CAP. Results The levels of prothrombin time, thrombin time, D-dimer,urea nitrogen, neutrophil to lymphocyte ratio (NLR) and the number of severe pneumonia cases in the anemia group were higher than those in the non-anemia group(P<0.05). The levels of C-reactive protein (CRP), lymphocyte, total protein, albumin, albumin-globulin ratio, indirect bilirubin, glutamic pyruvic transaminase and creatine kinase isoenzyme in the anemia group were significantly lower than those in the non-anemia group (P<0.05). There were no significant differences between the two groups in white blood cell count and procalcitonin (P>0.05). Logistic regression analysis showed that anemia, CRP, D-dimer, NLR, urea nitrogen and creatinine were the independent risk factors of death in the elderly patients with CAP (P<0.05). Conclusions Anemia is an independent risk factor for the death of the elderly patients with CAP. More attention should be paid to the hemoglobin management in clinical practice.

Key words: pneumonia, aged, anemia, prognosis, clinical characteristic

中图分类号:

R 563.1

彭泽通, 张尧, 刘斌. 贫血对老年社区获得性肺炎死亡的影响分析[J]. 实用老年医学, 2024, 38(3): 260-264.

PENG Zetong, ZHANG Yao, LIU Bin. Analysis of the effects of anemia on death in elderly patients with community-acquired pneumonia[J]. Practical Geriatrics, 2024, 38(3): 260-264.

参考文献

[1] LIN C J, CHANG Y C, TSOU M T, et al. Factors associated with hospitalization for community-acquired pneumonia in home health care patients in Taiwan [J]. Aging Clin Exp Res, 2020, 32(1): 149-155.
[2] HESPANHOL V, BáRBARA C. Pneumonia mortality, comorbidities matter? [J]. Pulmonology, 2020, 26(3): 123-129.
[3] 中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版) [J]. 中华结核和呼吸杂志, 2016, 39(4): 253-279.
[4] Nutritional anaemias. Report of a WHO scientific group [J]. World Health Organ Tech Rep Ser, 1968, 405: 5-37.
[5] DOSHI S M, RUEDA A M, CORRALES-MEDINA V F, et al. Anemia and community-acquired pneumococcal pneumonia [J]. Infection, 2011, 39(4): 379-383.
[6] STAUDER R, VALENT P, THEURL I. Anemia at older age: etiologies, clinical implications, and management [J]. Blood, 2018, 131(5): 505-514.
[7] WANG Y, PING Y J, JIN H Y, et al. Prevalence and health correlates of anaemia among community-dwelling Chinese older adults: the China Health and Retirement Longitudinal Study [J]. BMJ Open, 2020, 10(10): e038147.
[8] OPPEN K, UELAND T, MICHELSEN A E, et al. Hepcidin predicts 5-year mortality after community-acquired pneumonia [J]. Infect Dis: Lond, 2022, 54(6): 403-409.
[9] GUO S, MAO X, LIANG M. The moderate predictive value of serial serum CRP and PCT levels for the prognosis of hospitalized community-acquired pneumonia [J]. Respir Res, 2018, 19(1): 193.
[10] LV C, SHI W, PAN T, et al. Exploration of aging-care parameters to predict mortality of patients aged 80-years and above with community-acquired pneumonia [J]. Clin Interv Aging, 2022, 17: 1379-1391.
[11] SILJAN W W, HOLTER J C, NYMO S H, et al. Cytokine responses, microbial aetiology and short-term outcome in community-acquired pneumonia [J]. Eur J Clin Invest, 2018, 48(1):e12865.
[12] WEISS G, GANZ T, GOODNOUGH L T. Anemia of inflammation [J]. Blood, 2019, 133(1): 40-50.
[13] BENOIT J L, BENOIT S W, DE OLIVEIRA M H S, et al. Anemia and COVID-19: a prospective perspective [J]. J Med Virol, 2021, 93(2): 708-711.
[14] TAO Z, XU J, CHEN W, et al. Anemia is associated with severe illness in COVID-19: a retrospective cohort study [J]. J Med Virol, 2021, 93(3): 1478-1488.
[15] HEGELUND M H, GLENTHøJ A, RYRSØ C K, et al. Biomarkers for iron metabolism among patients hospitalized with community-acquired pneumonia caused by infection with SARS-CoV-2, bacteria, and influenza [J]. Apmis, 2022, 130(9): 590-596.
[16] WANG Y, NAN L, HU M, et al. Significant association between anemia and higher risk for COVID-19 mortality: a meta-analysis of adjusted effect estimates [J]. Am J Emerg Med, 2022, 58: 281-285.
[17] HE Y, CHEN Y, CAO K, et al. Effect of anemia on readmission and death in octogenarian patients with lower respiratory tract infections: a retrospective cohort study [J]. Int J Clin Pract, 2022, 2022: 4566936.

贫血对老年社区获得性肺炎死亡的影响分析

Analysis of the effects of anemia on death in elderly patients with community-acquired pneumonia

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