老年慢性阻塞性肺疾病合并呼吸衰竭病人预后影响因素分析  

Study on the related prognostic factors in the elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure

作　　者：王彦宏[1] 郝东侠 WANG Yan-hong;HAO Dong-xia(Department of Geriatric;Department of Emergency,Space Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院老年医学一科,北京市100049 [2]航天中心医院急诊科,北京市100049

出　　处：《实用老年医学》2018年第10期970-972,共3页Practical Geriatrics

摘　　要：目的探讨老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭病人血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平变化及预后的影响因素。方法将68例COPD合并呼吸衰竭病人根据预后分为康复组(n=51)和死亡组(n=17),记录2组病人基础资料,对比2组病人动脉血气指标和血清PCT、TNF-α水平差异,分析影响COPD合并呼吸衰竭病人预后的危险因素。结果康复组病人病程及吸烟指数均明显小于死亡组(P<0. 05)。康复组病人PaO_2和p H值均明显高于死亡组,PaCO_2及血清PCT、TNF-α水平则显著低于死亡组(P<0. 05或P<0. 01)。病程长及PaCO_2、血清PCT、TNF-α水平升高是影响COPD合并呼吸衰竭病人预后的独立危险因素。结论血清PCT、TNF-α水平与COPD合并呼吸衰竭病人预后密切相关。Objective To investigate the changes of serum levels of procalcitonin（ PCT）,tumor necrosis factor-α（ TNF-α） and to analyze the related prognostic factors in the elderly patients with chronic obstructive pulmonary disease（ COPD） complicated with respiratory failure. Methods A total of 68 patients with COPD complicated respiratory failure were divided into rehabilitation group（ n = 51）and death group（ n = 17） according to the prognosis. The basic clinical data were recorded and the arterial blood gas index,serum levels of PCT,TNF-α were compared between the two groups. The prognostic factors of COPD complicated respiratory failure were analyzed. Results The duration of disease and the smoking index in rehabilitation group were significantly less than those in death group（ P〈0. 05）. There were no significant difference in gender,age and BMI between two groups（ P〈0. 05）.The levels of PaO2 and pH in rehabilitation group were significantly higher and the levels of PaCO2,PCT,TNF-α were significantly lower than those in death group（ P〈0. 05）. The duration of disease,PaCO2 and serum levels of PCT,TNF-α were the related prognostic factors of patients with COPD complicated respiratory failure. Conclusions The serum levels of PCT and TNF-α are closely related to the prognosis of patients with COPD complicated with respiratory failure.

关 键 词：呼吸衰竭 慢性阻塞性肺疾病 降钙素原 肿瘤坏死因子-Α 

分 类 号：R563.8[医药卫生—呼吸系统]