AECOPD气道黏液高分泌患者临床特征及对不良预后的风险因素分析  

Clinical Characteristics and Risk Factors for Poor Prognosis of AECOPD Patients with Airway Mucus Hypersecretion

作　　者：万绮琪 肖体江 甘华林 朱玲 谢浩 Wan Qiqi;Xiao Tijiang;Gan Hualin(Department of Respiratory and Intensive Care Unit,The Fourth People’s Hospital of Nanhai District,Foshan,Guangdong,528000,China)

机构地区：[1]佛山市南海区第四人民医院呼吸与危重症医学科,广东佛山528000

出　　处：《黑龙江医学》2024年第11期1321-1324,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨慢性阻塞性肺疾病急性加重(AECOPD)气道黏液高分泌患者临床特征及对不良预后的风险因素分析。方法:选取2019年2月—2022年8月佛山市南海区第四人民医院收治的208例AECOPD气道黏液高分泌患者作为研究对象,结合患者临床治疗后预后情况分为良好预后组(n=142)与不良预后组(n=66)。比较两组患者各项临床特征的差异情况,明确患者不良预后发生的主要危险因素。结果:AECOPD气道黏液高分泌患者患病期间肺功能状态呈不同程度损伤,炎性指标水平显著升高,且主要表现出咳嗽、咳痰、发热及呼吸困难等临床症状。单因素分析结果显示,肺功能分级、炎性指标及咯血或痰血、胸痛、肺不张、消瘦症状均对AECOPD气道黏液高分泌患者不良预后的发生有重要影响。二元logistic回归分析结果显示,AECOPD气道黏液高分泌患者不良预后的主要危险因素包括肺功能Ⅳ级、CRP、PCT、咯血或痰血、胸痛、肺不张、消瘦症状,差异有统计学意义(OR=4.913、5.815、7.364、5.692、4.633、4.712、4.805,P<0.05)。结论:AECOPD气道黏液高分泌患者肺功能日益恶化,炎性反应逐渐加剧,临床针对此类患者进行肺功能评估、炎性指标检测及临床症状鉴别可为后续治疗方案的制定与改善提供数据支持,对患者预后结局的改善有积极意义。Objective:To investigate the clinical characteristics and risk factors for poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with airway mucus hypersecretion.Methods:A total of 208 patients with AECOPD airway mucus hypersecretion admitted to the hospital from February 2019 to August 2022 were selected as the research objects.According to the prognosis of patients after clinical treatment,they were divided into good prognosis group(n=142)and poor prognosis group(n=66).The differences of clinical characteristics between the two groups were compared,and the main risk factors of poor prognosis were identified.Results:The pulmonary function status of AECOPD patients with airway mucus hypersecretion showed different degrees of injury during the illness,and the level of inflammatory indicators was significantly increased.The main clinical symptoms were cough,expectoration,fever and dyspnea.Univariate analysis showed that pulmonary function grade,inflammatory indicators,hemoptysis or sputum blood,chest pain,atelectasis,and wasting symptoms all had important effects on the occurrence of poor prognosis in patients with AECOPD airway mucus hypersecretion.The results of binary logistic analysis showed that the main risk factors for poor prognosis in patients with AECOPD were pulmonary function gradeⅣ,CRP,PCT,hemoptysis or sputum blood,chest pain,atelectasis,and wasting symptoms(OR=4.913,5.815,7.364,5.692,4.633,4.712,4.805;P<0.05).Conclusion:The pulmonary function of AECOPD patients with airway mucus hypersecretion is deteriorating,and the inflammatory response is gradually intensified.The clinical evaluation of pulmonary function,inflammatory index detection and clinical symptom identification of such patients can provide data support for the formulation and improvement of subsequent treatment plan,and has positive significance for the improvement of the prognosis of patients.

关 键 词：慢性阻塞性肺疾病急性加重 气道黏液高分泌 临床特征 不良预后 风险因素 

分 类 号：R563.8[医药卫生—呼吸系统]