影响社区获得性肺炎疗效的多因素分析  

Seeking for factors to the efficacy of CAP therapy

作　　者：程克文[1] 周丽[1] 沈乃君[1] 张有志[1] 张奕[1] 

机构地区：[1]复旦大学附属华山医院宝山分院呼吸科,上海200431

出　　处：《临床肺科杂志》2009年第12期1583-1584,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的初步探索影响社区获得性肺炎疗效的多种因素,为指导社区获得性肺炎治疗提供依据。方法收集华山医院宝山分院呼吸内科在06年8月至08年5月收治的333例社区获得性肺炎(CAP)患者,采集患者的相关信息,把治疗结果分级(治愈、好转、未愈)后,利用SPSS13.0的Ordinal过程建立治疗结果Y对可疑影响因子X的比例优势模型Logistic回归。结果模型有统计学意义(χ2=51.986,P=0.000),拟合优度较佳(Devianceχ2=399.132,P=1.000)。年龄、动脉血氧分压(PaO2)、尿素氮(BUN)、咳痰4个因素对治疗效果的影响具有统计学意义(P<0.05)。治疗效果随年龄增加而趋劣(OR=1.020),随PaO2增加而趋优(OR=0.985),随BUN增加而趋劣(OR=1.170)。与无咳痰症状的患者相比,有咳痰症状的患者治疗效果趋优(OR=0.390)。结论年龄、PaO2、BUN、咳痰是本院333例CAP患者疗效的统计学影响因子,其中PaO2和咳痰是疗效的促进因子,年龄、BUN、无咳痰是疗效的劣化因子。Objective Basic seeking for possible factors to the efficacy of Community - aquired pneumonia （CAP） therapy. Provide information for further study. Methods Acquire information of 333 hospital registered CAP patients. Divide the efficacy of therapy into three parts （cured, better, negative）. Use SPSS 13.0 to develop I.ogistic regression model on Y （efficacy） to X （possible factors）. Result The model was statistically effective （X^2 =51.986,P =0.000） and well fitted （Deviance X^2=399.132,P= 1.000）. Age, BUN, PaO2 , cough were statistical factors to efficacy of therapy （ P 〈 0.05）. Efficacy of therapy went lower with the increase of age （ OR = 1.020） and BUN （ OR = 1.170） . Efficacy of therapy went higher with the increase of PaO2 （ OR =0.985） and coughing patient （ to the non-coughing one, OR = 0.390）. Conclusion Age, BUN, PaO2 , cough were statistical factors to efficacy of therapy. PaO2 and cough were promotive factors to therapy. Age, BUN, non-cough were inhibitive factors to therapy.

关 键 词：肺炎 疗效 因子 社区获得性肺炎 LOGISTIC回归 

分 类 号：R563.1[医药卫生—呼吸系统] R644[医药卫生—内科学]