老年慢性阻塞性肺部疾病并多器官衰竭的临床特征和危险因素分析

Clinical Characteristics and Risk Factors in Chronic Obstructive Pulmonary Disease with Multiple Organ Falure in the Ederly

目的探讨老年慢性阻塞性肺部疾病(COPD)并多器官衰竭(MOF)的临床特征和危险因素。方法回顾性分析87例老年COPD并MOF患者的临床资料。结果老年COPD并MOF的发生率为30.5%,病死率为41.4%;发生衰竭的器官依次为肺、心脏、脑、肾脏、肝脏、胃肠和血液,出现肾功能衰竭者全部死亡;器官衰竭数目越多,病死率越高;pH值越低、氧分压越低、二氧化碳分压短期内迅速上升,器官衰竭数目越多;感染、酸碱失衡、低蛋白血症是COPD并MOF的主要危险因素。结论老年COPD患者易发生MOF,随MOF数目增加病死率增加,对COPD急性加重期合并高危因素患者积极治疗可提高MOF的救治成功率。

Objective To investigate the clinical characteristics and risk factors of chronic obstructive pulmonary disease （COPD） with multiple organ failure （MOF） in the elderly. Methods A retrospective analysis was made of the clinical data of 87 cases of elderly COPD with MOF. Results The morbidity was 30.5% and the mortality was 41.4%.The failure organs in a decrease order were lungs, heart,brain, kidneys, liver, gastrointestinal and blood.All the cases with renal failure died. The lower the blood pH and PaO2 or the higher the PaCO2,the higher the fatality rate.The risk factors of COPD with MOF in the elderly were infection, acid-base imbalance and hypoproteinemia. Conclusion Organ failure is easy to develop in elderly COPD and the mortality will increase with failure in more organs. It＇s important and effective to treat the risk factors for reducing the mobidity of MOF and increase the survival rate in the acute exacerbation COPD.