基于80岁年龄分层的新冠患者临床特征 比较分析

Comparative Analysis of Clinical Characteristics in COVID-19 Patients Stratified by Age of 80

摘要: 目的：比较80岁以上与80岁以下新型冠状病毒感染(COVID-19)患者的临床特征、实验室指标及并发症差异。方法：回顾性收集40例COVID-19住院患者的临床资料，按年龄分为<80岁组(21例)与≥80岁组(19例)，对比两组间基线特征、临床表现及血生化、凝血功能、炎症指标等项目。结果：≥80岁组高血压患病率显著高于<80岁组(73.7% vs. 33.3%, P = 0.011)，而发热的发生率较低(57.9% vs. 85.7%, P = 0.049)。血液检测数据显示，≥80岁组患者白细胞(WBC)、中性粒细胞(N)、血红蛋白(HB)、纤维蛋白原(FIB)、丙氨酸氨基转移酶(ALT)及乳酸脱氢酶(LDH)均显著低于<80岁组(均P < 0.05)，而D-二聚体(D dimer)和血尿素氮(BUN)水平显著升高(P < 0.05)。结论：>80岁的COVID-19患者更常合并高血压，且炎症反应与肝损伤指标相对较低，但凝血功能异常及肾功能负荷较高，提示年龄是影响临床表型及病理生理反应的重要因素。

Abstract: Objective: To compare the differences in clinical characteristics, laboratory parameters, and complications between COVID-19 patients aged ≥80 years and those aged <80 years. Methods: Clinical data of 40 hospitalized patients with COVID-19 were retrospectively collected and divided into two groups according to age: <80 years group (21 cases) and ≥80 years group (19 cases). Baseline characteristics, clinical manifestations, blood biochemistry, coagulation function, and inflammatory markers were compared between the two groups. Results: The prevalence of hypertension in the ≥80 years group was significantly higher than that in the <80 years group (73.7% vs. 33.3%, P = 0.011), while the incidence of fever was lower (57.9% vs. 85.7%, P = 0.049). Laboratory tests showed that white blood cell count (WBC), neutrophil count (N), hemoglobin (HB), fibrinogen (FIB), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) in the ≥80 years group were significantly lower than those in the <80 years group (all P < 0.05), while D-dimer and blood urea nitrogen (BUN) levels were significantly higher (P < 0.05). Conclusion: Elderly COVID-19 patients are more likely to have hypertension, with relatively lower inflammatory response and liver injury indicators, but higher coagulation abnormalities and renal burden, suggesting that age is an important factor affecting clinical phenotype and pathophysiological response.