国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
7期
533-536
,共4页
叶树鸣%梁志欣%李影%陈良安
葉樹鳴%樑誌訢%李影%陳良安
협수명%량지흔%리영%진량안
急性呼吸窘迫综合征%预后%危险因素%回归分析
急性呼吸窘迫綜閤徵%預後%危險因素%迴歸分析
급성호흡군박종합정%예후%위험인소%회귀분석
Acute respiratory distress syndrome%Prognosis%Risk factors%Regression analysis
目的 研究不同严重程度急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者的病死危险因素.方法 回顾性研究解放军总医院2000年1月至2012年6月收治的符合2012年ARDS柏林定义的患者的临床资料,根据氧和指数将其分为轻、中度组及重度组,分别采用单因素及多因素Logistic回归分析各种因素与病死率之间的关系.结果 纳入189例患者,年龄18～89岁,平均(52.9±18.2)岁,轻、中、重度患者分别24例、102例及63例,病死率分别为20.8％、45.1％及63.5％.多因素Logistic回归分析显示预测轻中度ARDS患者病死的危险因素包括:确诊前住院时间＞48 h及急性生理学和慢性健康评价(APACHEⅡ)评分;预测重度患者病死的危险因素包括:序贯性器官功能衰竭评分及确诊时处于免疫抑制状态.结论 不同严重程度ARDS患者的预后危险因素不同,因此对于轻中度ARDS患者,应更加重视早期诊断及开始相应的治疗;而对于重度患者,应注重及早发现及保护出现功能障碍的器官和免疫调理治疗.
目的 研究不同嚴重程度急性呼吸窘迫綜閤徵(acute respiratory distress syndrome,ARDS)患者的病死危險因素.方法 迴顧性研究解放軍總醫院2000年1月至2012年6月收治的符閤2012年ARDS柏林定義的患者的臨床資料,根據氧和指數將其分為輕、中度組及重度組,分彆採用單因素及多因素Logistic迴歸分析各種因素與病死率之間的關繫.結果 納入189例患者,年齡18～89歲,平均(52.9±18.2)歲,輕、中、重度患者分彆24例、102例及63例,病死率分彆為20.8％、45.1％及63.5％.多因素Logistic迴歸分析顯示預測輕中度ARDS患者病死的危險因素包括:確診前住院時間＞48 h及急性生理學和慢性健康評價(APACHEⅡ)評分;預測重度患者病死的危險因素包括:序貫性器官功能衰竭評分及確診時處于免疫抑製狀態.結論 不同嚴重程度ARDS患者的預後危險因素不同,因此對于輕中度ARDS患者,應更加重視早期診斷及開始相應的治療;而對于重度患者,應註重及早髮現及保護齣現功能障礙的器官和免疫調理治療.
목적 연구불동엄중정도급성호흡군박종합정(acute respiratory distress syndrome,ARDS)환자적병사위험인소.방법 회고성연구해방군총의원2000년1월지2012년6월수치적부합2012년ARDS백림정의적환자적림상자료,근거양화지수장기분위경、중도조급중도조,분별채용단인소급다인소Logistic회귀분석각충인소여병사솔지간적관계.결과 납입189례환자,년령18～89세,평균(52.9±18.2)세,경、중、중도환자분별24례、102례급63례,병사솔분별위20.8％、45.1％급63.5％.다인소Logistic회귀분석현시예측경중도ARDS환자병사적위험인소포괄:학진전주원시간＞48 h급급성생이학화만성건강평개(APACHEⅡ)평분;예측중도환자병사적위험인소포괄:서관성기관공능쇠갈평분급학진시처우면역억제상태.결론 불동엄중정도ARDS환자적예후위험인소불동,인차대우경중도ARDS환자,응경가중시조기진단급개시상응적치료;이대우중도환자,응주중급조발현급보호출현공능장애적기관화면역조리치료.
Objective To determine the predictors of in-hospital mortality in patients with acute respiratory distress syndrome (The Berlin Definition).Methods The clinical data of 189 patients with acute respiratory distress syndrome (ARDS) from January 2000 to June 2012 were collected and analyzed.All patients were divided into mild-moderate group and severe group accord to PaO2/FiO2.Univariate and multivariate logistic regression analyses were performed to assess the association between the risk factors and the mortality.Results Of the 189 cases analyzed,age ranged from 18 to 89 years [mean age (52.9 ± 18.2) years].There are 24 patients with mild ARDS,102 patients with moderate ARDS,and 63patients with severe ARDS,the in-hospital mortality was 20.8％,45.1％ and 63.5％,respectively.Multivariate logistic regression analyses indicated that predictors of in-hospital mortality in patients with mild-moderate ARDS were APACHE Ⅱ and duration of hospital stay before ARDS onset ＞ 48 h,and predictors of in hospital mortality in patients with severe ARDS were mmunosuppression and Sequential Organ Failure Assessment scores.Conclusions Predictors of in-hospital mortality between ARDS patients with different severity may be different.For patients with mild moderate ARDS,we should pay more attention to early diagnosis and began to the corresponding treatment.Whereas for patients with severe ARDS,early detection and protection of failure organs and immunomodulating therapy may be more important.
