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老年人患有血液感染的临床特征和危险因素

Mengxi Ding¹, Yachan Ning², Lipo Song²

¹Department of General Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.

|May 31, 2025

目的:

研究老年人血流感染的临床特征及危险因素。

方法:

这是一项前瞻性队列多中心研究。根据纳入和排除标准，将2020年12月至2023年6月期间疑似血流感染的老年患者纳入分析，以评估老年患者血流感染的临床特征。

结果:

共纳入338例疑似血流感染的老年患者，其中141例确诊为血流感染。革兰阴性菌所占比例（47.5%）与革兰阳性菌相近（46.1%），但略高于革兰阳性菌。血流感染常见的临床表现包括发热（75.2%）、意识水平下降（24.8%）、寒战（14.2%）、休克（12.1%）等。多因素回归分析显示，入院时降钙素原水平升高（OR = 2.008，95%CI 1.258–3.206，P = 0.003）、心率 > 90次/分（OR = 2.104，95%CI 1.302–3.400，P = 0.002）、动脉血二氧化碳分压 < 32 mmHg（OR = 1.922，95%CI 1.025–3.601，P = 0.042）以及冠心病（OR = 1.909，95%CI 1.134–3.213，P = 0.015）是老年患者发生血流感染的独立危险因素。

结论:

老年人血流感染中革兰阴性菌与革兰阳性菌的比例相似。老年人血流感染常见的临床特征为发热和意识水平下降，血流感染与非血流感染在全身临床表现方面无显著差异。高降钙素原（PCT）水平、心率 > 90 次/分钟、动脉二氧化碳分压（PaCO2）< 32 mmHg 以及基础冠心病是老年人血流感染的独立危险因素。

关键词:

血流感染血流感染临床特征临床特征风险因素风险因素年长的成年人.

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