Analysis on the clinical characteristics and influencing factors of senile viral complicated bacterial pneumonia
HAN Fan1,2 ZHONG Guofu1,2 YE Ye1,2 ZHENG Min′an1,2 WANG Dawei1,2,3 LIU Yuntao1,2,3,4▲
1.Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510120, China; 2.Department of Emergency, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangdong Province, Guangzhou 510120, China;
3.Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangdong Province, Guangzhou 510120, China;
4.Key Laboratory of Traditional Chinese Medicine Prevention and Control of Infectious Diseases, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangdong Province, Guangzhou 510120, China
Abstract：Objective To identify the clinical characteristics and related influencing factors of senile viral bacterial pneumonia by comparing it with simple bacterial infectious pneumonia. Methods A case-control trial was designed to study elderly patients with pneumonia diagnosed in the emergency treatment, observation, comprehensive ward hospitalization department of Guangdong Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as “our hospital”) from January 2016 to June 2018. The patients who were clearly diagnosed as respiratory virus infection by etiology were in the viral complicated bacterial pneumonia group. The patients were matched by age and gender at 1∶1, and the elderly patients with simple bacterial infection diagnosed in our hospital at the same time were selected as the simple bacterial pneumonia group, with 70 cases in each group. The basic clinical information, previous medical history, clinical symptoms and signs, laboratory examination results and pathogenic indicators of patients in the two groups were collected. The clinical characteristics and related influencing factors of senile viral complicated bacterial pneumonia were studied by intergroup comparison and logistic regression. Results Parainfluenza virus, influenza virus B and influenza virus A were the main infectious agents of senile pneumonia. The proportion of diabetes mellitus, cerebrovascular disease and malignant tumor in the viral complicated bacterial pneumonia group was higher than that in the simple bacterial pneumonia group, the incidence rate of cough and shortness of breath was lower than that of bacterial pneumonia group, the average body temperature was higher than that of bacterial pneumonia group, the abnormal proportion of white blood cell count, neutrophils, calcitonin, hypersensitive C-reactive protein, blood lactic acid, carbon dioxide partial pressure in arterial blood, total bilirubin, prothrombin time, international standardized ratio, D-Dimer and other indicators were higher than those of the simple bacterial pneumonia group, the abnormal proportion of red blood cell count and hemoglobin were lower than those in the simple bacterial pneumonia group, and the differences were statistically significant (all P ＜ 0.05). Correlation analysis showed that patients with diabetes, associated with shortness of breath, abnormal blood carbon dioxide partial pressure, abnormal blood lactic acid, and abnormal total bilirubin may be associated with viral complicated bacterial pneumonia, while abnormal hemoglobin may be associated with simple bacterial pneumonia (P ＜ 0.05). Conclusion Parainfluenza virus and influenza virus are the main pathogens of senile viral complicated bacterial pneumonia patients. Diabetes may increase the risk of senile viral complicated bacterial pneumonia. Associated with shortness of breath, blood carbon dioxide partial pressure, blood lactic acid, total bilirubin and other abnormalities, may indicate the possibility of viral complicated bacterial pneumonia.
2020, Vol. 17 
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