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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2023年04期

页码:

550-553

栏目:

临床研究

出版日期:

2023-08-20

文章信息/Info

Title:

-

作者:

熊 锋¹; 娄建丽²

201599 上海,上海市第六人民医院金山分院急诊科¹、普外科²

Author(s):

-

关键词:

急性加重期; 肺疾病; 慢性阻塞性;  预后;  临床分析

Keywords:

-

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2023.04.026

摘要:

目的 分析慢性阻塞性肺病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)预后影响因素,建立预测模型。方法 选择2019年6月至2022年6月我院收治的AECOPD患者79例,将预后不良21例为观察组,58例为对照组,比较两组基础资料、实验室结果等指标,多因素Logistics回归分析。结果 观察组中13例行有创机械通气,8例住院期间死亡; 对照组经治疗后病情平稳,出院1个月后无再次急性发作。两组呼吸频率(25.57±2.40 vs. 23.27±3.89)、嗜酸性粒细胞(113.74±45.79 vs. 162.84±64.41)、血红蛋白(115.26±13.28 vs. 122.56±10.60)、尿素氮(9.91±1.27 vs. 8.67±2.32)、PaCO₂(67.19±11.66 vs. 60.01±12.77)、乳酸(2.74±0.74 vs. 2.20±0.65),P<0.05。多因素Logistics回归发现呼吸频率(OR= 0.815,95%CI: 0.681～0.976)、尿素氮(OR=0.725,95%CI: 0.539～0.977)、PaCO₂(OR=0.945,95%CI: 0.903～0.988)、乳酸(OR= 0.380,95%CI: 0.176～0.821)是AECOPD不良预后的危险因素,嗜酸性粒细胞(OR=1.013,95%CI: 1.002～1.024)、血红蛋白(OR=1.061,95%CI: 1.009～1.116)是AECOPD预后不良的保护性因素。绘制列线图,预后不良相关因素C-index为0.902(95%CI: 0.856～0.949),AUC为0.902(95%CI: 0.855～0.950),平均绝对误差0.053。结论 呼吸频率、嗜酸性粒细胞、血红蛋白、尿素氮、PaCO₂、乳酸等指标是AECOPD患者预后不良的影响因素,早期识别、早期救治重症患者具有临床意义。

Abstract:

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参考文献/References:

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备注/Memo

备注/Memo:

收稿日期:2023-02-07)
通信作者: 熊 锋, Email: 3294115947@qq.com

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更新日期/Last Update: 2023-08-20