中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
18期
1374-1377
,共4页
李婧%赵海金%王凤燕%董航明%蔡绍曦
李婧%趙海金%王鳳燕%董航明%蔡紹晞
리청%조해금%왕봉연%동항명%채소희
肺疾病,慢性阻塞性%死亡率%危险因素%疾病严重程度
肺疾病,慢性阻塞性%死亡率%危險因素%疾病嚴重程度
폐질병,만성조새성%사망솔%위험인소%질병엄중정도
Pulmonary disease,chronic obstructive%Mortality%Risk factors%Severity of illness
目的 探讨影响慢性阻塞性肺疾病急性加重(AECOPD)患者住院期间病死率的危险因素.方法 回顾性分析南方医院呼吸与危重症医学科2010年1月至2012年8月因AECOPD住院治疗的182例患者的临床资料.搜集和分析患者一般资料、稳定期情况、肺功能、血常规、血气分析、C反应蛋白(CRP)等指标,对影响患者预后的危险因素进行Logistic多因素回归分析.结果 182例患者中死亡42例,好转140例.死亡组患者中稳定期综合评估急性加重风险高、低外周血淋巴细胞计数、高CRP、合并贫血、低蛋白血症、高碳酸血症、慢性肺源性心脏病、缺血性心脏病方面的所占比例分别为90.4％、73.8％、50.0％、50.0％、71.4％、64.3％、76.1％、19.0％,好转组分别为70.0％、47.1％、17.1％、27.1％、46.4％、30.7％、40.7％、7.0％,组间差异均有统计学意义(均P＜0.05).高CRP(OR=3.226,P=0.009)、高碳酸血症(OR=2.928,P=0.013)、慢性肺源性心脏病(OR=2.510,P=0.045)、低外周血淋巴细胞计数(OR=2.488,P=0.045)是影响AECOPD患者住院期间死亡的独立危险因素.结论 低外周血淋巴细胞、高CRP、高碳酸血症、慢性肺源性心脏病是影响AECOPD患者住院期间死亡的独立危险因素.
目的 探討影響慢性阻塞性肺疾病急性加重(AECOPD)患者住院期間病死率的危險因素.方法 迴顧性分析南方醫院呼吸與危重癥醫學科2010年1月至2012年8月因AECOPD住院治療的182例患者的臨床資料.搜集和分析患者一般資料、穩定期情況、肺功能、血常規、血氣分析、C反應蛋白(CRP)等指標,對影響患者預後的危險因素進行Logistic多因素迴歸分析.結果 182例患者中死亡42例,好轉140例.死亡組患者中穩定期綜閤評估急性加重風險高、低外週血淋巴細胞計數、高CRP、閤併貧血、低蛋白血癥、高碳痠血癥、慢性肺源性心髒病、缺血性心髒病方麵的所佔比例分彆為90.4％、73.8％、50.0％、50.0％、71.4％、64.3％、76.1％、19.0％,好轉組分彆為70.0％、47.1％、17.1％、27.1％、46.4％、30.7％、40.7％、7.0％,組間差異均有統計學意義(均P＜0.05).高CRP(OR=3.226,P=0.009)、高碳痠血癥(OR=2.928,P=0.013)、慢性肺源性心髒病(OR=2.510,P=0.045)、低外週血淋巴細胞計數(OR=2.488,P=0.045)是影響AECOPD患者住院期間死亡的獨立危險因素.結論 低外週血淋巴細胞、高CRP、高碳痠血癥、慢性肺源性心髒病是影響AECOPD患者住院期間死亡的獨立危險因素.
목적 탐토영향만성조새성폐질병급성가중(AECOPD)환자주원기간병사솔적위험인소.방법 회고성분석남방의원호흡여위중증의학과2010년1월지2012년8월인AECOPD주원치료적182례환자적림상자료.수집화분석환자일반자료、은정기정황、폐공능、혈상규、혈기분석、C반응단백(CRP)등지표,대영향환자예후적위험인소진행Logistic다인소회귀분석.결과 182례환자중사망42례,호전140례.사망조환자중은정기종합평고급성가중풍험고、저외주혈림파세포계수、고CRP、합병빈혈、저단백혈증、고탄산혈증、만성폐원성심장병、결혈성심장병방면적소점비례분별위90.4％、73.8％、50.0％、50.0％、71.4％、64.3％、76.1％、19.0％,호전조분별위70.0％、47.1％、17.1％、27.1％、46.4％、30.7％、40.7％、7.0％,조간차이균유통계학의의(균P＜0.05).고CRP(OR=3.226,P=0.009)、고탄산혈증(OR=2.928,P=0.013)、만성폐원성심장병(OR=2.510,P=0.045)、저외주혈림파세포계수(OR=2.488,P=0.045)시영향AECOPD환자주원기간사망적독립위험인소.결론 저외주혈림파세포、고CRP、고탄산혈증、만성폐원성심장병시영향AECOPD환자주원기간사망적독립위험인소.
Objective To explore the risk factors for hospitalization case fatality of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A retrospective review of medical records was performed for 182 hospitalized AECOPD patients at Nanfang Hospital from January 2010 to August 2012.Their general information,condition in stable stage,the results of spirometry,blood routine test,blood gas analysis and C-reactive protein (CRP) were collected and analyzed.The risk factors for mortality were analyzed by multivariable Logistic regression.Results Among them,42 died during hospitalization.Univariate analysis revealed that 8 factors had significant differences between two groups (all P ＜ 0.05):high exacerbation risk (death vs improvement group,90.4％ vs 70.0％),low peripheral absolute lymphocyte count (73.8％ vs 47.1％),high CRP (50.0％ vs 17.1％),concurrent anemia (50.0％ vs 27.1％),hypoproteinemia (71.4％ vs 46.4％),hypercapnia (64.3％ vs 30.7％),chronic pulmonary heart disease (76.1％ vs 40.7％) and ischemic heart disease (19.0％ vs 7.0％).By multiple Logistic regression analysis,high CRP (OR =3.226,P =0.009),hypercapnia (OR =2.928,P =0.013),chronic pulmonary heart disease (OR =2.510,P =0.045),low peripheral absolute lymphocyte count (OR =2.488,P =0.045) were the independent risk factors for hospitalization case fatality of AECOPD patients.Conclusion Low peripheral absolute lymphocyte count,high CRP,hypercapnia and chronic pulmonary heart disease were the independent risk factors for mortality in hospitalized AECOPD patients.
