社区老年COPD患者流感抗原阳性与急性加重风险的相关性回顾分析

Retrospective Analysis of the Correlation between Influenza Antigen Positive and Acute Exacerbation Risk in Elderly COPD Patients in Community

摘要: 目的：探讨社区老年慢性阻塞性肺疾病(COPD)患者流感抗原阳性与急性加重风险的相关性，为社区COPD患者的流感防控和病情管理提供依据。方法：回顾性选取2021年1月至2025年12月于珠海市中西医结合医院拱北社区健康服务中心诊断为COPD的老年(≥60岁)患者76例，根据流感抗原检测结果分为阳性组(40例)和阴性组(36例)。收集两组基线资料，随访至少6个月，比较两组急性加重发生情况，并采用多因素Logistic回归分析流感抗原阳性与急性加重风险的独立关联。结果：两组年龄、性别、吸烟史及合并高血压、糖尿病比例差异均无统计学意义(P > 0.05)，阳性组FEV1%预计值低于阴性组(P < 0.05)。阳性组AECOPD年发生率高于阴性组[(1.10 ± 1.06)次/年比(0.50 ± 0.65)次/年，P < 0.01]，首次急性加重时间短于阴性组[(69.84 ± 24.69)天比(105.67 ± 35.79)天，P < 0.01]。多因素Logistic回归分析显示，流感抗原阳性是发生≥1次中重度AECOPD的边缘危险因素(OR = 2.955, 95%CI: 0.956~9.133, P = 0.060)，合并糖尿病是急性加重的独立危险因素(OR = 4.268, P = 0.026)。结论：社区老年COPD患者中，流感抗原阳性者肺功能基线更差，急性加重发生风险呈增高趋势。建议加强社区老年COPD患者的流感筛查与疫苗接种，以延缓疾病进展。

Abstract: Objective: To explore the correlation between influenza antigen positive and acute exacerbation risk in elderly patients with chronic obstructive pulmonary disease (COPD) in community, and to provide evidence for influenza prevention and control and disease management of COPD patients in community. Methods: From January 2021 to December 2025, 76 elderly patients (≥60 years old) diagnosed with COPD in Gongbei Community Health Service Center of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine were retrospectively selected and divided into positive group (40 cases) and negative group (36 cases) according to the results of influenza antigen detection. The baseline data of the two groups were collected and followed up for at least 6 months. The incidence of acute exacerbation was compared between the two groups, and the independent association between influenza antigen positive and acute exacerbation risk was analyzed by multivariate Logistic regression. Results: There was no significant difference in age, sex, smoking history and the proportion of hypertension and diabetes between the two groups (P > 0.05), and the predicted FEV1% in the positive group was lower than that in the negative group (P < 0.05). The annual incidence of AECOPD in the positive group was higher than that in the negative group [(1.10 ± 1.06) times/year ratio (0.50 ± 0.65) times/year, P < 0.01], and the first acute exacerbation time was shorter than that in the negative group (69.84 ± 24.69) days compared with (105.67 ± 35.79) days. Multivariate Logistic regression analysis showed that influenza antigen positive was a marginal risk factor for moderate and severe AECOPD (OR = 2.955, 95% CI: 0.956~9.133, P = 0.060), and diabetes mellitus was an independent risk factor for acute exacerbation (OR = 4.268, P = 0.026). Conclusion: Among the elderly COPD patients in the community, the baseline of lung function is worse in patients with influenza antigen positive, and the risk of acute exacerbation is increasing. It is suggested to strengthen influenza screening and vaccination for elderly COPD patients in community to delay the disease progress.