Konishi M, Sawaki M, Mikasa K, Maeda K, Mori K, Sakamoto M, Tsujimoto M, Takeuchi S, Hamada K, Kunimatsu M
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1994 Aug;68(8):966-72. doi: 10.11150/kansenshogakuzasshi1970.68.966.
A clinical study was conducted to clarify the clinical state of pneumonia in elderly patients using transtracheal aspiration (TTA). Without prior administration of antibiotics, S. pneumoniae was the most clinically significant in both elderly and non-elderly groups whether the onset of pneumonia was hospital acquired pneumonia or community acquired pneumonia. Compared to the non-elderly group, multiple pathogens were isolated more frequently in the elderly group. Analysis about host factors showed that the number of underlying diseases per patient was more along those with poorer general conditions in the elderly group. The Brinkmann Index was also significantly higher in the elderly group. Clinical examinations before onset of pneumonia indicated that serum total protein, albumin and DNCB skin reaction were significantly lowered in the elderly group. Over the clinical course, the prognosis was poorer and the incidence of adverse reactions of antibiotics tended to be more in the elderly group. These results suggest that a complex clinical background exists for pneumonia of elderly people, related to poorer prognosis. Therefore, more cautious and meticulous care should be provided to elderly patients with pneumonia.
进行了一项临床研究，以阐明使用经气管抽吸术（TTA）的老年患者肺炎的临床状况。在未预先使用抗生素的情况下，无论肺炎的发病是医院获得性肺炎还是社区获得性肺炎，肺炎链球菌在老年组和非老年组中都是临床上最重要的。与非老年组相比，老年组中更频繁地分离出多种病原体。对宿主因素的分析表明，老年组中每位患者的基础疾病数量更多，且一般状况较差。老年组的布林克曼指数也显著更高。肺炎发病前的临床检查表明，老年组的血清总蛋白、白蛋白和二硝基氯苯皮肤反应显著降低。在临床过程中，老年组的预后较差，抗生素不良反应的发生率也往往更高。这些结果表明，老年人肺炎存在复杂的临床背景，与较差的预后相关。因此，对于老年肺炎患者应给予更谨慎和细致的护理。
