老年冠心病患者PCI术后肺部感染危险因素及其模型构建  

Risk factors for postoperative pulmonary infection in elderly coronary heart disease patients undergoing PCI and establishment of model

作　　者：吴黎明[1] 李娜[1] 罗珊[1] 赵彩杰 王建辉 WU Li-ming;LI Na;LUO Shan;ZHAO Cai-jie;WANG Jian-hui(Tangshan Vocational and Technical College,Tangshan,Hebei O63300,China;不详)

机构地区：[1]唐山职业技术学院护理系,河北唐山063300 [2]唐山市工人医院护理部,河北唐山063300

出　　处：《中华医院感染学杂志》2023年第10期1490-1494,共5页Chinese Journal of Nosocomiology

基　　金：河北省社会科学基金项目(HB19SH001)。

摘　　要：目的探讨老年冠心病(CHD)患者经皮冠状动脉介入(PCI)术后肺部感染的危险因素及其模型构建。方法根据术后是否发生肺部感染将2020年1月-2022年1月于唐山市工人医院行PCI术的250例CHD老年患者分为感染组30例和未感染组220例。分析两组患者临床资料及实验室检查结果,单因素及多因素Logistic回归分析老年CHD患者PCI术后肺部感染的危险因素。构建Logistic回归模型,通过绘制受试者工作特征(ROC)曲线评估模型对老年CHD患者PCI术后肺部感染的预测价值。结果多因素Logistic回归分析结果显示,年龄大、外周血CD_(4)^(+)水平低、有吸烟史、有侵入性操作、外周血血红蛋白(Hb)水平<90 g/L是老年CHD患者PCI术后肺部感染的独立危险因素(P<0.05)。构建的回归方程模型为logit(P)=-9.875+年龄×1.324+外周血CD_(4)^(+)水平×1.232+吸烟史×1.045+侵入性操作×1.345+外周血Hb水平×0.983。ROC曲线分析显示,当logit(P)>12.050时,模型预测老年CHD患者PCI术后肺部感染诊断敏感度为80.00%,特异度为74.09%。结论年龄大、外周血CD_(4)^(+)水平低、有吸烟史、有侵入性操作、外周血Hb水平<90 g/L是老年CHD患者PCI术后肺部感染的危险因素,Logistic回归模型对其预测价值较高,临床可针对以上情况的患者采取相应治疗及干预措施,以降低肺部感染的风险。OBJECTIVE To explore the risk factors for postoperative pulmonary infection in elderly coronary heart disease(CHD)patients undergoing percutaneous coronary intervention(PCI)and established the model.METHODS A total of 250 CHD elderly patients who underwent PCI in Tangshan Workers′Hospital from Jan 2020 to Jan 2022 were enrolled in the study and were divided into the infection group with 30 cases and the no infection group with 220 cases according to the status of postoperative pulmonary infection.The clinical data and laboratory test indexes were observed and compared between the two groups of patients.Univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the postoperative pulmonary infection in the elderly CHD patients.Logistic regression model was established,and the value of the model in prediction of the postoperative pulmonary infection was evaluated by receiver operating characteristic(ROC)curves.RESULTS The result of multivariate logistic regression analysis showed that the old age,low level of peripheral blood CD_(4)^(+),smoking history,invasive operation and peripheral blood hemoglobin(Hb)level less than 90 g/L were the independent risk factors for the postoperative pulmonary infection in the elderly CHD patients undergoing PCI(P<0.05).The regression equation model was logit(P)=-9.875+age×1.324+peripheral blood CD_(4)^(+)level×1.232+smoking history×1.045+invasive operation×1.345+peripheral blood Hb level×0.983.ROC curve analysis indicated that when the logit(P)was greater than 12.050,the sensitivity of the model was 80.00%in diagnosis of the postoperative pulmonary infection in the elderly CHD patients undergoing PCI,with the specificity 74.09%.CONCLUSION The old age,low level of peripheral blood CD_(4)^(+),smoking history,invasive operation and peripheral blood Hb level less than 90 g/L are the risk factors for the postoperative pulmonary infection in the elderly CHD patients undergoing PCI.The logistic regression model has high prediction value

关 键 词：冠心病 老年 经皮冠状动脉介入术 术后感染 肺部感染 危险因素 回归模型 

分 类 号：R619.3[医药卫生—外科学]