重症肺炎死亡患者的早期临床特征及死亡预测因素分析  

The Earlier Clinical Features of Severe Community-Acquired Pneumonia and Predictive Factors of Death by Logistic Regression Analysis

作　　者：李飞[1] 李惠[2] 

机构地区：[1]郑州人民医院呼吸科,河南郑州450003 [2]武汉市汉口医院内三科,湖北武汉430312

出　　处：《中国呼吸与危重监护杂志》2013年第3期249-252,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的了解重症肺炎死亡患者的临床特点,探讨与死亡相关的预后因素。方法采用回顾性研究分析郑州人民医院2008年7月至2012年2月住院的125例重症肺炎的数据,对生存患者(109例)与死亡患者(16例)的临床特点进行比较。结果死亡组和生存组基础疾病数量不同,死亡组患者患有更多基础疾病(P<0.05)。死亡组患者入院时心率高于生存组患者(P<0.05)。死亡组有合并症比例及合并症数量、入院前最高体温、入院时血小板数量、动脉血pH、PaO2、HCO3-、氧合指数(PaO2/FiO2)均低于生存组患者(P均<0.05)。Logistic回归显示基础疾病数量、心率及PaO2是重症肺炎患者死亡的预测因素。结论基础疾病数量、心率及PaO2对于重症肺炎具有较高的死亡预测价值。Objective To investigate the clinical characteristics and risk factors associated with death in critically ill patients with severe community-acquired pneumonia（CAP）. Methods A retrospective analysis was carried out in 125 hospitalized patients with severe CAP admitted from July 2008 to February 2012. Earlier clinical features were compared between 109 survival patients and 16 dead patients, and logistic regression analysis was conducted. Results The death group had more underlying diseases than the survival group（P 〈0.05）. The heart rate at admission in the death group was significantly higher than that in the survival group（P 〈 0.05）. The ratio and number of complication,the highest temperature before admission, the platelet count, the arterial blood pH, PaO2 and PaO2/FiO2 in the death group were significantly lower than those in the survival group （ P 〈 0.05 ）. Logistic regression analysis showed that the number of underlying diseases,heart rate and PaO2 were predictors of death in the patients with severe pneumonia. Conclusion The number of underlying diseases, heart rate and PaO2 has highly predictive value of death for severe CAP.

关 键 词：重症肺炎 危险因素 代谢性酸中毒 

分 类 号：R563.1[医药卫生—呼吸系统]