住院肺结核患者合并急性呼吸窘迫综合征的多因素分析

Multivariate Analysis of Acute Respiratory Distress Syndrome in Patients with Pulmonary Tuberculosis

目的探讨导致住院肺结核患者合并急性呼吸窘迫综合征（ARDS）的危险因素。方法收集2006年1月～2007年10月内科收冶的肺结核患者1931例，合并ARDS的患者91例作为观察组（ARDS组），非ARDS患者采用随机方法选取病例作为对照组（非ARDS组），比较2组各项观察指标，行单因素分析对有显著性差异的指标进行多因素分析，以发现肺结核患者导致ARDS的多种相关因素，单因素分析采用Х^2检验，多因素分析采用Logistic回归分析。结果1931例住院肺结核患者中，91例合并ARDS，占住院肺结核患者的4．71％（91／1931）。经多因素分析，复治肺结核患者、合并慢性阻塞性肺疾病（COPD）、合并休克、血常规示白细胞增加、中性粒细胞百分比增加与住院肺结核患者发生ARDS相关，且均为危险因素。结论住院肺结核患者中，复治肺结核患者、合并COPD、休克、全身性感染者更易发生ARDS。

Objective To evaluate the risk factors of acute respiratory distress syndrome （ARDS） in patients with pulmonary tuberculosis（PTB）. Method Retrospectively study disease history, clinical and laboratory data of hospitalized adult patients with pulmonary TB from Jan 2006 to Oct 2007 treated in our hospital . The observed data was identified by univariate and multivariate analysis. Result Of 1931 pulmonary TB patients, 91 developed ARDS. 184 patients who did not developed ARDS were randomized chosen to constitute the control group. The pulmonary TB patients with retreatment, chronic obstructive lung disease （ COPD）, shock, elevated leukocyte count and neutrophilic percent are prone to develop ARDS. Conclusion The patients with retreatment pulmonary tuberculosis , COPD , shock, sepsis, are associated with ARDS developmentin pulmonary TB patients.