支气管扩张症合并慢性阻塞性肺疾病急性加重患者住院死亡的相关因素  

Death risk factors of hospitalized patients with bronchiectasis complicated with acute exacerbation of chronic obstructive pulmonary disease

作　　者：邹外龙[1] 闫磊[1] 张鑫[1] 杨琴 陈济超[1] ZOU Wai-Long;YAN Lei;ZHANG Xin;YANG Qin;CHEN Ji-Chao(Department of Respiratory Diseases,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院呼吸科,北京100049

出　　处：《中华老年多器官疾病杂志》2021年第8期590-594,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.19089-2)。

摘　　要：目的回顾性分析支气管扩张症合并慢性阻塞性肺疾病急性加重(AECOPD)患者住院死亡的相关因素。方法选取航天中心医院呼吸科2015年1月至2020年6月收治的111例支气管扩张症合并AECOPD住院患者为研究对象。根据不同预后结果将患者分为存活组与死亡组,收集2组患者的一般资料、临床表现、肺功能、实验室检查及住院时间等进行分析,筛查影响患者住院死亡风险的相关因素。采用SPSS 24.0统计软件进行数据处理。根据数据类型,分别采用t检验、χ^(2)检验或Mann-Whitney秩和检验进行组间比较。采用logistic回归分析死亡风险因素。结果共筛选出31个风险因素进行分析。单因素分析显示,2组患者年龄、合并基础疾病、体质量指数(BMI)、粒细胞/淋巴细胞比值(NLR)、血清白蛋白(Alb)、铜绿假单胞菌感染、最大呼气第1秒呼出气量的容积占预计值百分比(FEV_(1)%pred)、动脉血气分析(BGA)、二氧化碳分压(PCO_(2))、氧合指数(OI)、胸部影像学Bhalla评分及每年症状持续时间比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,NLR、FEV_(1)%pred及Bhalla评分是支气管扩张症合并AECOPD患者的死亡危险因素。结论NLR升高、FEV_(1)%pred下降及胸部影像学Bhalla评分低是支气管扩张症合并AECOPD患者死亡的独立危险因素。Objective To retrospectively analyze the related factors of hospitalized death in patients with bronchiectasis complicated with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 111 patients with bronchiectasis complicated with AECOPD admitted in our hospital from January 2015 to June 2020 were enrolled in this study.According to their prognostic outcomes,they were divided into survival group and death group.The general information,clinical manifestations,lung function,results of laboratory examinations and length of hospital stay were collected and analyzed to screen the related factors affecting the in-hospital mortality in the two groups.SPSS statistics 24.0 was used for the data analysis.According to the data types,Chi-square test,student′s t test or Mann-Whitney rank sum test were employed for intergroup comparison.Logistic regression analysis was adopted to analyze the risk factors of death.Results A total of 31 risk factors were screened out for analysis.Univariate analysis showed that there were significant differences in age,underlying comorbidities,body mass index(BMI),granulocyte/lymphocyte ratio(NLR),serum albumin(ALB),pseudomonas aeruginosa infection,forced expiratory volume in one second as percentage of predicted volume(FEV_(1)%pred),blood gas analysis(BGA),partial pressure of carbon dioxide(PCO_(2)),oxygenation index(OI),Bhalla score of chest imaging and annual symptom duration between the two groups(P<0.05).Multivariate logistic regression analysis indicated that NLR,FEV_(1)%pred and Bhalla score were risk factors for death in patients with bronchiectasis complicated with AECOPD.Conclusion Increased NLR,decline of FEV_(1)%pred and low Bhalla score of chest imaging are independent risk factors for death in patients with bronchiectasis complicated with AECOPD.

关 键 词：支气管扩张症 慢性阻塞性肺疾病 急性加重期 死亡风险 

分 类 号：R562.22[医药卫生—呼吸系统] R563.9[医药卫生—内科学]