中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
21期
161-164
,共4页
老年%社区获得性肺炎%C-反应蛋白
老年%社區穫得性肺炎%C-反應蛋白
노년%사구획득성폐염%C-반응단백
Elderly%Community-acquired pneumonia%C-reactive protein
目的：探讨高龄老人社区获得性肺炎（CAP）的临床特点以及C-反应蛋白（CRP）检测在老年CAP中的临床应用价值。方法从基础疾病、化验、检查、伴随症状等方面分析2009年1月~2013年12月在空军总医院干部病房住院的120例80岁以上社区获得性肺炎患者，并观察治疗前后血清CRP水平，比较治疗前患者CRP、体温、白细胞计数情况。结果高龄老年CAP患者的临床症状不典型，容易出现神经系统症状，以革兰阴性杆菌感染为主。治疗前CRP阳性（>8 mg/L）107例（89.2%），体温阳性（>37℃）64例（53.3%），白细胞计数阳性（>10×109/L）39例（32.5%），CRP阳性率显著高于体温、白细胞计数的阳性率，差异有统计学意义（P<0.05）。治疗后CRP≤8 mg/L患者由治疗前13例增加至105例，治疗前、后比较，差异有统计学意义（P<0.05）。结论临床医师座掌握老年CAP患者的发病特点，尽早及时、全面治疗，CRP可作为早期诊断老年CAP及判断疗效的敏感指标。
目的：探討高齡老人社區穫得性肺炎（CAP）的臨床特點以及C-反應蛋白（CRP）檢測在老年CAP中的臨床應用價值。方法從基礎疾病、化驗、檢查、伴隨癥狀等方麵分析2009年1月~2013年12月在空軍總醫院榦部病房住院的120例80歲以上社區穫得性肺炎患者，併觀察治療前後血清CRP水平，比較治療前患者CRP、體溫、白細胞計數情況。結果高齡老年CAP患者的臨床癥狀不典型，容易齣現神經繫統癥狀，以革蘭陰性桿菌感染為主。治療前CRP暘性（>8 mg/L）107例（89.2%），體溫暘性（>37℃）64例（53.3%），白細胞計數暘性（>10×109/L）39例（32.5%），CRP暘性率顯著高于體溫、白細胞計數的暘性率，差異有統計學意義（P<0.05）。治療後CRP≤8 mg/L患者由治療前13例增加至105例，治療前、後比較，差異有統計學意義（P<0.05）。結論臨床醫師座掌握老年CAP患者的髮病特點，儘早及時、全麵治療，CRP可作為早期診斷老年CAP及判斷療效的敏感指標。
목적：탐토고령노인사구획득성폐염（CAP）적림상특점이급C-반응단백（CRP）검측재노년CAP중적림상응용개치。방법종기출질병、화험、검사、반수증상등방면분석2009년1월~2013년12월재공군총의원간부병방주원적120례80세이상사구획득성폐염환자，병관찰치료전후혈청CRP수평，비교치료전환자CRP、체온、백세포계수정황。결과고령노년CAP환자적림상증상불전형，용역출현신경계통증상，이혁란음성간균감염위주。치료전CRP양성（>8 mg/L）107례（89.2%），체온양성（>37℃）64례（53.3%），백세포계수양성（>10×109/L）39례（32.5%），CRP양성솔현저고우체온、백세포계수적양성솔，차이유통계학의의（P<0.05）。치료후CRP≤8 mg/L환자유치료전13례증가지105례，치료전、후비교，차이유통계학의의（P<0.05）。결론림상의사좌장악노년CAP환자적발병특점，진조급시、전면치료，CRP가작위조기진단노년CAP급판단료효적민감지표。
Objective To explore the clinical characteristics of over 80 years elderly patients with community-acquired pneumonia and the value of C-reactive protein detection. Methods From January 2009 to December 2013, in Cadres ward of Air Force General Hospital, 120 over 80 years old CAP patients were analyzed include basic diseases, laborato-ry test, auxiliary examination and accompanying symptoms. The CRP level was observed before and after the treatment, and the CRP level, temperature, white blood cell count were compared before treatment. Results The clinical symptoms of the elderly patients with CAP were atypical and prone to nervous system symptoms, mainly infected by Gram nega-tive bacilli. Before treatment, CRP positive (>8 mg/L) patients were 107 cases (89.2%) and temperature positive (>37℃) patients were 64 cases (53.3%), and white blood count positive (>10í109/L) patients were 39 cases (32.5%). The posi-tive rate of CRP was significantly higher than those of temperature and white blood count, the differences were statis-cally significaut (P<0.05). After treatment, CRP≤8 mg/L patients were 105 more than 13 cases before the treatment, the difference was statistically significant (P<0.05). Conclusion The clinicians should master the clinical characteris-tic of elderly patients with CAP, and thke comprehensive treatment as soon as possible. The CRP level can be a sensi-tive index of early diagnosis and curative in senile community-acquired pneumonia.
