COPD急性加重合并活动性肺结核患者的危险因素及临床特征分析  

Risk factors of acute exacerbation of chronic obstructive pulmonary disease in patients with active pulmonary tuberculosis

作　　者：谢一潋[1] 褚金国[1] 钱国清[1] 李国祥[1] 

机构地区：[1]宁波市第一医院感染科,315000

出　　处：《浙江医学》2016年第5期339-341,共3页Zhejiang Medical Journal

基　　金：宁波市科技计划项目(2013A610233)

摘　　要：目的分析慢性阻塞性肺疾病（CORD）急性加重合并活动性肺结核患者的危险因素及临床特征，以指导临床治疗。方法选取COPD急性发作合并活动性肺结核患者42例（合并组）及同期单纯COPD急性发作的患者72例（对照组），比较两组患者的临床特征，并采用单因素分析及logistic回归分析其危险因素。结果两组患者的部分临床特征有统计学差异（均P〈0．05）。单因素分析表明，吸烟史、营养不良、长期吸入糖皮质激素史及既往有肺结核史是COPD急性发作合并活动性肺结核的主要危险因素（均P〈0．05）。多因素分析发现，营养不良（OR=4．100，95％a：1．471～11．431）、长期吸入糖皮质激素史（OR=2．695，95％CI：1．078～6．739）及既往肺结核史（OR=11．102，95％CI：3．076—40．065）为独立危险因素（均P〈0．05）。结论根据危险因素早期识别合并活动性肺结核的高危COPD患者，可尽早明确诊断，给予积极治疗。Objective To analysis the risk factors of acute exacerbation of chronic obstructive pulmonary disease （COPD） in patients with active pulmonary tuberculosis （sputum positive）. Methods The clinical data of 42 active pulmonary tuberculosis patients with acute exacerbation COPD （case group） and 72 patients with acute exacerbation COPD （controt group） admitted in the same period were analyzed. Univariate analysis and multivariate logistic regression were used for statistical analysis. Results Univariate analysis revealed that smoking history, malnutrition, history of long-term intake of inhaled cortieosteroids （ICS）, history of tuberculosis were associated with exacerbation of COPD combined with pulmonary tuberculosis （all P〈0.05）. Multivariate logistic regression analysis identified malnutrition （OR=4.100, 95%CI：1.471 - 11.431）, history of long-term ICS intake （OR=2.695, 95%CI： 1.078 -6.739） and history of tuberculosis （OR=11.102, 95% CI： 3.076 -40.065） were independent risk factors for exacerbation of COPD combined with pulmonary tuberculosis. Conclusion The high-risk acute exacerbation COPD patients with tuberculosis infection should be identified according to risk factors and the appropriate management should be given to improve therapeutic efficacy.

关 键 词：慢性阻塞性肺疾病 肺结核 危险因素 

分 类 号：R521[医药卫生—内科学] R563.9[医药卫生—临床医学]