老年多器官功能不全综合征465例危险因素分析  

Risk factors analysis of 465 cases of multiple organ dysfunction syndrome in the elderly

作　　者：赵志锐 王慧娟[2] 张鑫[1] 郭超[3] 解立新[1] 

机构地区：[1]中国人民解放军总医院呼吸科,北京100853 [2]北京朝阳医院呼吸科,北京100020 [3]阜外心血管病医院,北京100037

出　　处：《海南医学》2014年第22期3293-3296,共4页Hainan Medical Journal

基　　金：国家自然科学基金项目(编号:81170008)

摘　　要：目的通过分析老年多器官功能不全综合征(MODSE)患者的临床特征,以了解影响患者预后的危险因素。方法研究共纳入465例MODSE患者并录入相应的各项临床指标,根据28 d病死率分为生存组和死亡组,对单因素Logistic回归分析两组间差异有统计学意义的指标进行多因素Logistic回归分析,得出影响预后的危险因素。结果生存组患者的平均年龄为(75.90±7.23)岁,小于死亡组的(77.97±6.94)岁,动脉血乳酸浓度为(1.39±1.10)mmol/L,低于死亡组的(3.15±3.67)mmol/L,功能不全器官数为(2.76±0.87)个,少于死亡组的(3.73±1.04)个,APACHEⅢ(64.35±24.32)分,低于死亡组的(96.10±29.74)分,以上各项指标间比较差异均有统计学意义(P<0.05)。经多因素Logistic回归分析显示,年龄(P=0.009)、动脉血乳酸浓度(P=0.002)、功能不全器官数(P<0.001)和APACHEⅢ(P<0.001)是MODSE患者死亡的独立危险因素。结论年龄、动脉血乳酸浓度、功能不全器官数和APACHEⅢ是MODSE患者死亡的独立危险因素。Objective To analyze the prognostic risk factors of patients with multiple organ dysfunction syndrome in the elderly（MODSE） by analyzing their clinical characteristics. Methods In this study, the clinical data of465 patients with MODSE were collected. The patients were divided into two groups, the survival group and the death group, basing on the 28 d mortality. Multivariable logistic regression analysis was performed on indicators which had statistically significant differences in the univariate logistic regression analysis. Results Multivariate Logistic regression analysis showed that the average age of the survival group（75.90±7.23） was younger than that of the death group（77.97±6.94）; the arterial blood lactate concentration of the survival group（1.39±1.10） was lower than that of the death group（3.15±3.67） mmol/L; the number of organ dysfunction cases of the survival group（2.76±0.87） was less than that of the death group（3.73 ± 1.04）; and the APACHE Ⅲ of the survival group（64.35 ± 24.32） was lower than that of the death group（96.10 ± 29.74）; differences between the above indexes were statistically significant. Therefore, age（P=0.009）, arterial blood lactate concentration（P=0.002）, numbers of dysfunctional organs（P〈0.001） and APACHE Ⅲ（P〈0.001） were the risk factors of the death for MODSE patients. Conclusion Age, arterial blood lactate concentration,numbers of dysfunctional organs and APACHE Ⅲ were all independent risk factors of death for MODSE patients.

关 键 词：多器官功能衰竭 危险因素 老年人 

分 类 号：R442.8[医药卫生—诊断学]