潘明伟 杨玲玲

摘要：目的 研究老年重症肺炎患者细胞炎性因子、凝血功能情况和预后的影响因素。方法 在2018年4月-2021年4月期间，随机抽取50例中国人民解放军联勤保障部队第923医院接收的老年肺炎患者进行研究。分为观察组25例（重症患者），对照组25例（普通患者），血清IL-6等炎性因子的含量利用酶联免疫吸附法（ELISA）进行检测，纤维蛋白原（Fib）等凝血功能情况利用全自动血凝分析仪进行检测，比较两组患者的检测结果。结果 与对照组相比，观察组患者的IL-6、IL-10 水平明显更高，TNF-α水平明显更低（p<0.05）。与对照组相比，观察组的PT、APTT、TT、Fib和D-二聚体水平均更高（P<0.05）。经过多因素 logistic 回归分析，主要影响老年重症肺炎预后的因素有FineV级以上、长期卧床、年龄（高）、机械通气、血红蛋白<90 g/L。结论 老年重症肺炎患者的凝血功能比较差，炎症比较严重，预后受机械通气、高龄、长期卧床、FineV级以上等因素的影响。

关键词：炎性因子;老年重症肺炎;凝血功能;预后;细胞炎性因子

【中图分类号】R563.1 【文献标识码】A 【文章编号】1673-9026（2021）05-137-02

Abstract：Objective To investigate the cell inflammatory factors，coagulation function and prognostic factors in elderly patients with severe pneumonia.Methods From April 2018 to April 2021，50 elderly patients with pneumonia admitted by the 923rd Hospital of the Joint Logistic Support Force of the People's Liberation Army were randomly selected for the study.The patients were divided into observation group （25 patients with severe disease） and control group （25 patients with normal disease）.The contents of inflammatory factors such as IL-6 in serum were detected by enzymy-linked immunosorbent assay （ELISA），and the coagulation function such as fibrinogen （FIB） was detected by automatic hemagglutination analyzer.The test results of the two groups were compared.Results Compared with the control group，the levels of IL-6 and IL-10 in observation group were significantly higher，and the level of TNF-α was significantly lower （P <0.05）.Compared with the control group，the levels of PT，APTT，TT，FIB and D-dimer in observation group were all higher （P<0.05）.After multivariate logistic regression analysis，the main factors affecting the prognosis of severe pneumonia in the elderly were FineV grade above，long-term bed rest，age （high），mechanical ventilation，and hemoglobin <90 g/L.Conclusion The elderly patients with severe pneumonia have poor coagulation function and severe inflammation，and the prognosis is affected by mechanical ventilation，advanced age，long-term bed rest，FineV grade or above and other factors.

Key word：inflammatory factors;Severe pneumonia in the elderly;Coagulation function;The prognosis;Cellular inflammatory factors

重癥肺炎属于呼吸系统疾病中较常见的类型，主要发病人群是老年人，老年重症肺炎患者的代谢能力较差，体抗力低，身体技能衰退，易并发炎症感染，影响患者的预后，对患者的身体健康和生命安全造成了严重的危害[1]。随着老龄化的加剧，生活环境的污染，老年重症肺炎的患病率越来越高。重症肺炎是因机体被感染，诱发机体全身性的炎性反应，大量释放的炎性因子会造成机体凝血功能受限[2]。本文主要研究老年重症肺炎患者细胞炎性因子、凝血功能情况和预后的影响因素，具体报告如下。

1资料与方法

1.1一般资料

在2018年4月-2021年4月期间，随机抽取50例中国人民解放军联勤保障部队第923医院接收的老年肺炎患者进行研究。分为观察组25例（重症患者），对照组25例（普通患者）。对照组中男性17例，女性8例，年龄最小是62岁，最大是95岁，平均年龄是（80.52±8.58）岁;观察组中男性16例，女性9例，年龄最小是60岁，最大是93岁，平均年龄是（81.26±9.14）岁。……