慢性阻塞性肺疾病合并社区获得性肺炎患者的临床特征及其影响因素分析  

Analysis of Clinical Characteristics and Influencing Factors of Patients with Chronic Obstructive Pulmonary Disease Complicated with Community-acquired Pneumonia

作　　者：石婷婷 刘双全 高晓华[2] 张锋英[2] SHI Ting-ting;LIU Shang-quan;GAO Xiao-hua;ZHANG Feng-ying(Department of Clinical Medicine,University of South China,Hengyang Medical School,Hengyang 421000,Hunan,China;Department of Respiratory and Critical Care Medicine,People's Hospital of Putuo District,Shanghai 200060,China)

机构地区：[1]南华大学衡阳医学院临床医学系,湖南衡阳421000 [2]上海市普陀区人民医院呼吸与危重症医学科,上海200060

出　　处：《医学信息》2022年第19期38-42,共5页Journal of Medical Information

基　　金：江苏大学2021年度临床医学科技发展基金项目(编号:JLY2021116)。

摘　　要：目的分析慢性阻塞性肺疾病合并社区获得性肺炎患者的临床特征及影响因素,旨在为有效控制慢性阻塞性肺疾病合并社区获得性肺炎及促进其转归提供依据。方法选取2019年10月-2020年9月普陀区人民医院收治的128例慢性阻塞性肺疾病患者作为研究对象,根据患者病史特点及肺部CT分为慢性阻塞性肺病合并社区获得性肺炎组(CAP-COPD组)及慢性阻塞性肺疾病急性加重组(AECOPD组),比较两组临床特征,分析影响因素。结果CAP-COPD组患者咳嗽加重、咳痰加重、气急加重、黄脓痰、发热、紫绀及肺部湿啰音占比均高于AECOPD组,差异有统计学意义(P<0.05);单因素分析结果显示,两组年龄、吸烟史、是否暴露有害粉尘或气体、高血压、糖尿病、低蛋白血症、Ⅱ型呼吸衰竭、机械通气、糖皮质激素长期吸入指标比较,差异有统计学意义(P<0.05);Logistic回归分析显示,糖尿病、年龄≥70岁、高血压、糖皮质激素长期吸入、机械性通气、低蛋白血症、Ⅱ型呼吸衰竭是CAP-COPD发病的主要影响因素。结论与AECOPD患者相比,CAP-COPD的临床症状更重,糖尿病、年龄≥70岁、高血压、糖皮质激素长期吸入、机械性通气、低蛋白血症、Ⅱ型呼吸衰竭是COPD并发肺炎发病的主要影响因素。Objective To analyze the clinical characteristics and influencing factors of patients with chronic obstructive pulmonary disease complicated with community-acquired pneumonia,in order to provide a basis for effectively controlling chronic obstructive pulmonary disease complicated with community-acquired pneumonia and promoting its prognosis.Methods A total of 128 patients with chronic obstructive pulmonary disease admitted to People's Hospital of Putuo District from October 2019 to September 2020 were selected as the research objects.According to the characteristics of the patient's medical history and lung CT,they were divided into chronic obstructive pulmonary disease with community-acquired pneumonia group(CAP-COPD group)and acute exacerbation of chronic obstructive pulmonary disease(AECOPD group).The clinical characteristics of the two groups were compared and the influencing factors were analyzed.Results The proportion of cough aggravation,sputum aggravation,shortness of breath aggravation,yellow purulent sputum,fever,cyanosis and pulmonary moist rales in CAP-COPD group was higher than that in AECOPD group,and the difference was statistically significant(P<0.05).The results of univariate analysis showed that there were significant differences in age,smoking history,exposure to harmful dust or gas,hypertension,diabetes,hypoproteinemia,type II respiratory failure,mechanical ventilation and long-term inhalation of glucocorticoids between the two groups(P<0.05).Logistic regression analysis showed that diabetes,age≥70 years old,hypertension,long-term inhalation of glucocorticoids,mechanical ventilation,hypoproteinemia and type II respiratory failure were the main influencing factors of CAP-COPD.Conclusion Compared with AECOPD patients,CAP-COPD has more severe clinical symptoms.Diabetes,age≥70 years,hypertension,long-term inhalation of glucocorticoids,mechanical ventilation,hypoproteinemia,and type II respiratory failure are the main influencing factors of COPD complicated with pneumonia.

关 键 词：慢性阻塞性肺疾病 社区获得性肺炎 气管-支气管感染 糖尿病 高血压 呼吸衰竭 机械通气 

分 类 号：R563[医药卫生—呼吸系统]