80岁以上老年社区获得性肺炎患者临床特点及血清C―反应蛋白表达的意义.docVIP

80岁以上老年社区获得性肺炎患者临床特点及血清C―反应蛋白表达的意义 　　[摘要] 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。 　　[关键词] 老年；社区获得性肺炎；C-反应蛋白 　　[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210（2015）07（c）-0161-04 　　[Abstract] 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， laboratory 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 negative 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 （10×109/L） patients were 39 cases （32.5%）. The positive rate of CRP was significantly higher than those of temperature and white blood count， the differences were statiscally 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 characteristic of elderly patients with CAP， and thke comprehensive treatment as soon as possible. The CRP level can be a sensitive index of early