194例老年社区获得性肺炎患者合并呼吸道病毒感染情况分析
Analysis of respiratory virus infection in 194 elderly patients with community-acquired pneumonia
余小丽 1陈愉生 1俞婷2
作者信息
- 1. 福建医科大学省立临床医学院,福州 350001;福建省立医院呼吸与危重症医学科
- 2. 福建医科大学省立临床医学院,福州 350001;福建省立医院干部特诊一科
- 折叠
摘要
目的 了解老年(≥65岁)社区获得性肺炎(CAP)合并呼吸道病毒感染情况及临床特点分析.方法 194例老年CAP患者,留取痰或肺泡灌洗液标本,采用实时荧光定量PCR法检测11种常见呼吸道病毒,收集患者的临床资料,比较不同年龄、季节老年CAP患者呼吸道病毒的检出情况.结果 194例老年CAP患者检出呼吸道病毒阳性40例(20.62%,40/194),其中单一病毒阳性37例、混合阳性3例,37例单一病毒阳性者分别为甲型流感(FLu-A)病毒阳性31例、呼吸道合胞病毒(RSV)阳性4例、副流感病毒2型(PIV2)阳性1例、人博卡病毒(HBOV)阳性1例,3例混合阳性者分别为FLu-A+PIV1阳性1例、Flu-A+PIV3阳性1例、FLu+RSV阳性1例.与病毒阴性者相比,存在呼吸道病毒感染的老年CAP患者年龄大,血清淋巴细胞计数与淋巴细胞比例下降,血清中性粒细胞比例升高,心功能Ⅱ级及以上比例高(P均<0.05).65～80岁、≥80岁的老年CAP患者检出呼吸道病毒阳性情况相比,P>0.05.与其他季节相比,秋季(9～11月)老年CAP患者痰或肺泡灌洗液标本FLu-A检出率高(P<0.05).结论 老年CAP患者合并呼吸道病毒感染较为常见,以FLu-A为主.存在淋巴细胞计数与淋巴细胞比例下降、血清中性粒细胞比例升高及心功能较差的高龄CAP患者较易合并呼吸道病毒感染.
Abstract
Objective To investigate the situation and clinical characteristics of respiratory virus infection in the elderly patients(≥65 years old)with community-acquired pneumonia(CAP).Methods This study included 194 el-derly CAP patients.Samples of sputum or bronchoalveolar lavage fluid were collected and tested for 11 common respira-tory viruses using real-time fluorescent quantitative PCR.Clinical data of the patients were also collected,and we compared the detection of respiratory viruses in elderly CAP patients of different ages and in different seasons.Results Among the 194 elderly CAP patients,respiratory viruses were detected in 40 cases(20.62%),including 37 cases with a single virus infection and 3 cases with mixed infections.The single virus infections included 31 cases of influenza A virus(Flu-A),4 cases of respiratory syncytial virus(RSV),1 case of parainfluenza virus type 2(PIV2),and 1 case of human bo-cavirus(HBOV).The three mixed infections were Flu-A+PIV1,Flu-A+PIV3,and Flu+RSV.Compared with the virus-negative patients,those with respiratory virus infections were older,had lower counts and percentages of lymphocytes,higher percentages of neutrophils,and a higher proportion of cardiac function class II or above(all P<0.05).No signifi-cant differences were found in the detection rates of respiratory viruses between patients aged 65-80 years and those over 80 years(all P>0.05).Compared with other seasons,the detection rate of Flu-A in sputum or bronchoalveolar lavage fluid was higher in the autumn(September to November)(P<0.05).Conclusion Respiratory virus infections are common in the elderly patients with CAP,predominantly caused by Flu-A.Elderly CAP patients with lower lympho-cyte counts and percentages,higher neutrophil percentages,and poor cardiac function are more susceptible to respirato-ry virus infections.
关键词
社区获得性肺炎/老年社区获得性肺炎/呼吸道病毒/呼吸道感染/病毒感染/呼吸道病毒感染/甲型流感病毒Key words
community-acquired pneumonia/community-acquired pneumonia in the elderly/respiratory virus/re-spiratory infection/viral infection/respiratory viral infection/influenza A virus引用本文复制引用
基金项目
国家重大科技专项(2017ZX10103004)
福建省卫生计生青年科研课题(2018-1-2)
出版年
2024
国家科技期刊平台
NSTL
万方数据