影响社区获得性肺炎住院时长的Logistic回归分析研究  

Logistic regression analysis of factors influencing hospitalization time for community acquired pneumonia

作　　者：韩桂玲[1] 于洋[1] 韩春生[1] 张纾难[1] HAN Gui-ling;YU Yang;HAN Chun-sheng(First Department of Traditional Chinese Medicine Pulmonary Disease,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院中医肺病一部,100029

出　　处：《中国实用医药》2021年第13期28-32,共5页China Practical Medicine

基　　金：国家自然科学基金(项目编号:81804044)。

摘　　要：目的回顾性研究社区获得性肺炎(CAP)住院患者的临床资料,探讨影响CAP住院时长的因素。方法选取135例CAP患者,采集患者的临床资料,均给予规范的抗生素治疗。分析既往病史对临床肺部感染评分量表(CPIS)评分及住院时长的影响,对CAP患者住院时长进行单因素及有序多分类Logistic回归分析,并分析入院时生物学指标与住院时长的关系。结果有无冠心病、糖尿病、高血压等病史对患者住院时长及CPIS评分均无影响,差异均无统计学意义(P>0.05)。根据单因素分析的结果 ,性别、年龄、气短、脉弱、喘息/憋气是住院时长的影响因素,差异具有统计学意义(P<0.05)。因为住院时长分为3个等级,因此SPSS拟合出2个累积概率回归方程。第1个方程:Logit(P=住院长)=-20.061-18.113×(气短=无)-18.893×(气短=轻)-0.997×(性别=男)-0.963×(年龄=低);第2个方程:Logit(P=住院长&中)=-17.885-18.113×(气短=无)-18.893×(气短=轻)-0.997×(性别=男)-0.963×(年龄=低)。两个方程只有常数项是不同的,平行线检验的结果 (χ2=3.504, P=0.941>0.05)表明,本次回归拟合出的2个方程中,自变量对应变量的影响是相同的(即每个自变量的偏回归系数在2个方程中保持一致)。Logistic回归分析显示,气短、女性、年龄较大(≥79岁)患者的住院时间更长(OR=0.000、0.369、0.382, P=0.000、0.005、0.028<0.05)。入院时的同型半胱氨酸(HCY)、D二聚体(D-D)和大动脉粥样硬化(LAA)能有效预测住院时长,回归方程:Y(d)=6.348+0.131×HCY+0.304×D-D+0.688×LAA;标准化的系数为0.266、0.196、0.184,说明HCY对住院时长的影响最大, D-D次之, LAA最小。结论性别、年龄、气短对患者住院时间的长短有影响,女性、≥79岁、中度到重度气短的患者住院时间更长一些;血清HCY、D-D和LAA水平对住院时长有影响。Objective To retrospectively study the clinical data of hospitalized patients with communityacquired pneumonia(CAP)and explore the factors influencing the hospitalization time of CAP patient.Methods The clinical data of 135 CAP patients were collected,and they all received standardized antibiotic treatment.The influence of past medical history on clinical pulmonary infection scale(CPIS)score and hospitalization time was analyzed.Univariate and ordered multi-category Logistic regression analysis was performed on hospitalization time in CAP patients,and the correlation between biological indicators and hospitalization time was analyzed.Results The factors of presence or absence of history of coronary heart disease,diabetes,hypertension had no influence on the hospitalization time and CPIS score,and the difference was not statistically significant(P>0.05).According to the results of univariate analysis,gender,age,shortness of breath,weak pulse,and wheezing/holding breath were the influencing factors of hospitalization time,and the difference was statistically significant(P<0.05).Because the hospitalization time was divided into three grades,SPSS fitted two cumulative probability regression equations.The first equation:Logit(P=long hospitalization time)=-20.061-18.113×(shortness of breath=none)-18.893×(shortness of breath=light)-0.997×(gender=male)-0.963×(age=low);the second equation:Logit(P=long&medium hospitalization time)=-17.885-18.113×(shortness of breath=none)-18.893×(shortness of breath=light)-0.997×(gender=male)-0.963×(age=low).Only the constant term of the two equations was different.The result of the parallel line test(χ2=3.504,P=0.941>0.05)showed that in the two equations fitted by this regression,the influence of the independent variable corresponding to the variable was the same(that was,the partial regression coefficient of each independent variable remains the same in the two equations).Logistic regression analysis showed that shortness of breath,women,and older patients(≥79 years old)had lo

关 键 词：社区获得性肺炎 住院时长 LOGISTIC回归分析 

分 类 号：R563.1[医药卫生—呼吸系统]