摘要
目的研究影响急性损伤/急性呼吸窘迫综合征(acute lung injury/acute respiratory distress syndrome,ALI/ARDS)患者的预后因素。方法回顾分析中国医学科学院肿瘤医院ICU2005年1月至2006年12月间全部63例ALI/ARDS患者的资料。根据病情转归分为生存组(n=39)和死亡组(n=24)。根据病因分为肺外型和肺内型。结果ALI/ARDS发病率为5.2%(63/1201)。单因素分析发现生存组和死亡组之间机械通气时间(P=0.028)、血肌酐水平(P=0.031)、氧合指数(P=0.023)、转入时APACHEH评分(P〈0.001)和转入时SOFA评分(P〈0.001)差异具有统计学意义。多因素分析发现仅转入时APACHEⅡ评分影响预后(P=0.015,OR:3.809,95%CI:1.295~11.203)。肺内型和肺外型两组之间1年生存率差异无统计学意义(63.9%VS.55.4%,P=0.982)。ARDS组和ALI组两组之间1年生存率差异具有统计学意义(44.9%vs.88.9%,P=0.008)。结论转入时患者A.PACHEⅡ评分是判断ALI/ARDS患者预后的独立危险因素,ALI/ARDS的病因不影响ALI/ARDS患者的生存。
Objective To investigate the factors influencing the outcomes of patients with ALI/ARDS. Method Data of 63 patients with ALI/ARDS in ICU, Cancer Hospital, Chinese Academy of Medical Science, from January 2005 to December 2006, were retrospectively analyzed. Patients were divided into survivor group ( n = 39) and non-survivor group ( n = 24) according to different outcomes, and equally, patients were classified in the respect of different causes as pulmonary origin and extra-pulmonary origin. Results The incidence of ALI/ARDS was 5.2 % (63/1201) in ICU. The univariate analysis showed that the differences in the length of mechanical ventilation ( P = 0.028), blood creatinine level ( P = 0.031), oxygenation index ( P = 0.023), between survivor group and non-survivor group. In addition, the differences in acute physiology and chronic health evaluation n (A- PACHE Ⅱ ) scores and sequential organ failure assessment (SOFA) on the admission day were significant between survival group and non-survival group (P 〈 0.001, respectively). Logistic regression analysis showed that A- PACHE Ⅱ scores was the only independent predictor of the mortality in patients with ALI/ARDS (P = 0.015, OR: 3.809, 95% CI:1.295 - 11.203). There was no significant difference in one-year survival between pulmonary origin cause of ALI/ARDS group and extra-pulmonary origin cause of ALI/ARDS group (63.9% vs. 55.4%). There was significant difference in one-year survival between ARDS and ALI group(44.9% vs. 88.9%, P 〈0.05). Conclusions APACHE Ⅱ seores onthe admission day of patients is the only independent predictor of the mortality in patients with ALI/ARDS, whereas the underlying cause of ALI/ARDS does not matter to the survival of patients.
出处
《中华急诊医学杂志》
CAS
CSCD
2008年第12期1263-1265,共3页
Chinese Journal of Emergency Medicine