慢性阻塞性肺疾病急性加重期合并症的研究分析  

Clinical analysis of the complications of acute exacerbation of chronic obstructive pulmonary disease

作　　者：汪倩 程朋朋 孙雨晴[1] 於海洋 崔志磊[1] 熊伟 韩锋锋[1] WANG Qian;CHENG Pengpeng;SUN Yuqing;YU Haiyang;CUI Zhilei;XIONG Wei;HAN Fengfeng(Department Of Respiratory Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medical,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院呼吸科,上海200092

出　　处：《世界临床药物》2021年第12期1113-1118,共6页World Clinical Drug

摘　　要：目的观察慢性阻塞性肺疾病急性加重期患者是否合并Ⅱ型呼吸衰竭临床特点的差异,探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)临床特点中对Ⅱ型呼吸衰竭及疾病预后影响的危险因素。方法分析我院既往收治的AECOPD患者临床资料,根据是否伴有Ⅱ型呼吸衰竭,将其分为A组:AECOPD伴有Ⅱ型呼吸衰竭109例;B组:AECOPD不伴有Ⅱ型呼吸衰竭117例。收集两组患者吸烟指数、患病年限、住院天数、急性加重次数、第一秒用力呼气容积占预计值百分比及活动性肺结核、肺栓塞、心血管疾病、糖尿病、精神系统疾病、贫血、肿瘤史、低蛋白血症、脑血管疾病、深静脉血栓形成、肾功能不全、免疫系统疾病等合并症。结果AECOPD患者中A组患病年限、吸烟指数、住院天数、急性加重次数、气流受限严重程度、合并症个数明显高于B组(P<0.05)。A组患者合并心力衰竭、冠状动脉粥样硬化性心脏病、脑血管疾病、贫血、低蛋白血症、活动性肺结核、深静脉血栓形成发生率显著高于B组(P<0.05)。其中,心力衰竭、冠状动脉粥样硬化性心脏病、脑血管疾病、贫血、低蛋白血症、活动性肺结核是AECOPD患者出现Ⅱ型呼吸衰竭的独立危险因素。结论AECOPD伴有Ⅱ型呼吸衰竭较无呼吸衰竭的患者合并症种类更多、临床表现及预后更差。在这些合并症中,心力衰竭、冠状动脉粥样硬化性心脏病、脑血管疾病、贫血、低蛋白血症、活动性肺结核对临床症状特别是呼吸系统症状影响更大。Objective To observe the differences in clinical characteristics of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with typeⅡrespiratory failure,and to explore the risk factors of AECOPD's clinical characteristics on typeⅡrespiratory failure and disease prognosis.Methods The clinical data of patients with AECOPD admitted to our hospital were retrospectively analyzed.According to whether they were accompanied by typeⅡrespiratory failure,they were divided into group A:109 patients with AECOPD accompanied by typeⅡrespiratory failure,Group B:117 AECOPD patients were not accompanied by typeⅡrespiratory failure.Collection of two groups of patients with smoking index,history of chronic obstructive pulmonary disease,hospital stays,the number of exacerbations,forced expiratory volume in the first second in percent predicted values and comorbidities(tuberculosis,pulmonary embolism,cardiovascular disease,diabetes,mental system disease,anemia,history of tumor,hypoalbuminemia,cerebrovascular disease,deep venous thrombosis,renal insufficiency,immune system diseases,etc.).Results Among these patients,the history of disease,smoking index,hospital stays,number of acute exacerbations,severity of airflow restriction,and number of comorbidities in group A were significantly higher than those in group B(P<0.05).The incidence rates of heart failure,coronary atherosclerotic heart disease,cerebrovascular disease,anemia,hypoproteinemia,tuberculosis and deep venous thrombosis in group A were significantly higher than those in group B(P<0.05).Among them,heart failure,coronary atherosclerotic heart disease,cerebrovascular disease,anemia,hypoproteinemia and tuberculosis were independent risk factors for typeⅡrespiratory failure in AECOPD patients.Conclusion AECOPD patients with typeⅡrespiratory failure had more comorbidities,worse clinical manifestations and worse prognosis than patients without respiratory failure.

关 键 词：慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 合并症 心血管疾病 

分 类 号：R563.9[医药卫生—呼吸系统]