老年慢性阻塞性肺疾病患者发生严重呼吸衰竭的流行病学特征及危险因素  

Epidemiological characteristics and risk factors of severe respiratory failure in elderly patients with chronic obstructive pulmonary disease

作　　者：袁圆[1] 杨思伟 罗再莲 YUAN Yuan;YANG Siwei;LUO Zailian(Department of Family Medicine,Zigong First People′s Hospital,Zigong,Sichuan 643000,China;Department of Emergency Medicine,Zigong First People′s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]四川省自贡市第一人民医院全科医学科,四川自贡643000 [2]四川省自贡市第一人民医院急诊医学科,四川自贡643000

出　　处：《公共卫生与预防医学》2023年第5期149-152,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的 分析老年慢性阻塞性肺疾病(COPD)患者发生严重呼吸衰竭的流行病学特征及危险因素。方法 选取2018年1月至2021年12月自贡市第一人民医院收治的COPD患者288例,根据住院期间是否发生严重呼吸衰竭分为对照组(未发生严重呼吸衰竭)和观察组(发生严重呼吸衰竭),采用单因素分析和logistic回归分析影响COPD患者发生严重呼吸衰竭的影响因素。结果 288例COPD患者中发生严重呼吸衰竭86例(29.86%),年龄≥70岁、男性患者发生严重呼吸衰竭比例明显较高(P<0.05);观察组FEV1和FEV1/FVC值明显低于对照组(P<0.05);观察组有呼吸困难和夜间憋醒比例明显高于对照组(P<0.05);年龄≥70岁(OR=4.092)、合并院内感染(OR=4.756)、合并低蛋白血症(OR=3.826)和每年急性加重次数>3次(OR=4.573)是老年COPD发生严重呼吸衰竭的危险因素(P<0.05)。结论 老年COPD住院患者发生严重呼吸衰竭风险较高,多发生于70岁以上男性患者,特别是对于年龄≥70岁、合并低蛋白血症、每年急性加重次数>3次、合并院内感染的患者应给予积极干预,可预防发生严重呼吸衰竭的风险。Objective To analyze the epidemiological characteristics and risk factors of severe respiratory failure in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 288 COPD patients admitted to Zigong First People′s Hospital from January 2018 to December 2021 were selected.The patients were divided into control group(no severe respiratory failure)and observation group(severe respiratory failure)according to whether severe respiratory failure occurred during hospitalization.The FEV1 and FEV1/FVC values and clinical symptoms of the two groups were compared.Univariate analysis and logistic regression analysis were used to analyze the influencing factors of severe respiratory failure in COPD patients.Results Among of 288 COPD patients,86 cases(29.86%)developed severe respiratory failure.The proportion of severe respiratory failure in male patients aged≥70 years was significantly higher(P<0.05).The values of FEV1 and FEV1/FVC in the observation group were significantly lower than those in the control group(P<0.05).The proportion of dyspnea and nocturnal awakening in the observation group were significantly higher than those in the control group(P<0.05).Age≥70 years old(OR=4.092),concurrent nosocomial infection(OR=4.756),concurrent hypoproteinemia(OR=3.826),and acute exacerbations>3 times per year(OR=4.573)were the risk factors for severe respiratory failure in elderly COPD patients(P<0.05).Conclusion The elderly COPD hospitalized patients have a higher risk of severe respiratory failure,and most of them are male patients over 70 years old.Especially for patients over 70 years old with hypoproteinemia,more than 3 acute exacerbations per year,and nosocomial infection,active intervention should be given to prevent the risk of severe respiratory failure.

关 键 词：慢性阻塞性肺疾病 严重呼吸衰竭 流行病学特征 

分 类 号：R181[医药卫生—流行病学]