郑慧敏

【摘要】 目的：评价莫西沙星治疗老年社区获得性肺炎（community acquired pneumonia，CAP）的效果及影响疗效相关因素。方法：回顾性分析181例经莫西沙星治疗的老年CAP患者的临床资料，根据治疗效果分为有效组和无效组，比较两组的各项指标，分析影响其疗效的相关因素。结果：有效组155例（85.63%），无效组26例（14.36%）;Logistic回归分析显示：病情程度、合并两种以上基础疾病、电解质紊乱和低蛋白血症是造成莫西沙星治疗失败的独立影响因素（P<0.05）。结论：莫西沙星是治疗老年CAP的理想药物，其疗效受患病程度、合并多种基础疾病、电解质紊乱及白蛋白水平等因素的影响，重视这些临床指标以便及早识别高危患者，制定有效的治疗策略，改善预后。

【关键词】 社区获得性肺炎 莫西沙星 疗效 相关因素 老年患者

doi：10.14033/j.cnki.cfmr.2019.28.017 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Multivariate Regression Analysis of Efficacy and Its Related Factors of Moxifloxacin in the Treatment of Elderly Community Acquired Pneumonia/ZHENG Huimin. //Chinese and Foreign Medical Research， 2019， 17（28）： -43

[Abstract] Objective： To evaluate the efficacy of Moxifloxacin in the treatment of community acquired pneumonia （CAP） in the elderly and its related factors. Method： The clinical data of 181 elderly CAP patients treated with Moxifloxacin were retrospectively analyzed. According to the therapeutic effect， they were divided into effective group and ineffective group. The indexes of the two groups were compared and the related factors affecting the therapeutic effect were analyzed. Result： There were 155 cases （85.63%） in the effective group and 26 cases （14.36%） in the ineffective group. Logistic regression analysis showed that the severity of the disease， the combination of more than two basic diseases， electrolyte disturbance and hypoalbuminemia were independent influencing factors for the failure of Moxifloxacin treatment （P<0.05）. Conclusion： Moxifloxacin is an ideal drug for the treatment of CAP in the elderly. Its efficacy is affected by the severity of the disease， combined with many basic diseases， electrolyte disturbance and albumin level. It is important to pay attention to these clinical indicators in order to identify high-risk patients as early as possible， formulate effective treatment strategies and improve prognosis.

[Key words] Community acquired pneumonia Moxifloxacin Efficacy Related factors Elderly patients

First-authors address： Fuzhou Economic and Technological Development Zone Hospital， Fuzhou 350015， China

社區获得性肺炎（community acquired pneumonia，CAP）是指在医院外获得的肺实质感染性炎症，临床症状以发热、咳嗽、伴或不伴咳痰、胸疼等为主，具有较高的发病率和死亡率[1-2]。老年人群由于身体功能退化、免疫功能下降、基础疾病多，成为CAP的高发人群，严重威胁老年人的健康状态及生活质量。目前，喹诺酮类药物是诊疗指南推荐的对于老年CAP有效的药物之一[3]，而作为新一代氟喹诺酮抗生素的莫西沙星因抗菌谱覆盖范围广、抗菌活性强、生物利用率高等优势成为当前治疗CAP的首选药物[4]。但老年患者作为特殊人群，其预后除了与莫西沙星治疗有关外，还受多种其他因素影响。鉴于此，本研究评价了莫西沙星治疗老年CAP的效果及影响疗效相关因素，旨在为临床合理用药提供依据，现报告如下。

1 资料与方法

1.1 一般资料

选入2016年1月-2018年12月笔者所在医院收治的老年CAP患者181例，其中男101例，女80例;年龄65～84岁，平均（71.95±4.68）岁;体质指数（BMI）20.5～28 kg/m2，平均（24.74±3.05）kg/m2;病程2～7 d，平均（5.16±1.24）d;病情程度：普通肺炎160例，重症肺炎21例。……