慢性阻塞性肺疾病急性加重期多器官功能衰竭的危险因素分析

Analysis on the risk factors for multiple organ dysfunction syndrome in acute exacerbation of chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病急性加重期多器官功能衰竭的危险因素。方法选择2004年1月至2009年11月住院的114例慢性阻塞性肺疾病急性加重期患者,按是否并发多器官功能衰竭分为两组:观察组为41例慢性阻塞性肺疾病急性加重期继发多器官功能衰竭的患者,对照组为73例为未发生多器官功能衰竭的慢性阻塞性肺疾病急性加重期患者。观察和对照采用统一的调查表,对研究资料先进行单因素分析,然后进行多因素非条件Logistic回归模型分析。结果经分析筛选出慢性阻塞性肺疾病的病程(OR=12.480)、COPD的治疗时机(OR=1.324)、有创通气(OR=11.055)、肺炎(OR=8.667)、持续发热(OR=3.836)这5个因素为慢性阻塞性肺疾病急性加重期伴多器官功能衰竭的独立危险因素。结论慢性阻塞性肺疾病急性加重期伴多器官功能衰竭与病程、有创通气关系最为密切,持续发热也可促发MODS。

Objective To explore risk factors for multiple organ dysfunction syndrome （MODS） in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD） with. Methods A total of 114 patients suffering from acute exacerbation of COPD hospitalized in the Department of Respiratory Medicine from January 2004 to November 2009 were divided into two groups： the study group （n=41, combined with MODS ） and the control group （n=73 without MODS）. Patients in the two groups were investigated by self-designed questionnaire, descriptive statistics, chi-square tests. Multivariate logistic regression were used to for statistical analysis. Results The duration of COPD （OR=12.480）, timing of treatment of COPD （OR=1.324）, invasive mechanical ventilation （OR=11.055）, pneumonia （OR=8.667）, persistent fever （OR=3.836）, were the independent risk factors for MODS. Conclusion The key risk factors for acute exacerbation of COPD with MODS are duration of COPD and invasive mechanical ventilation. Persistent fever also promote the occurrence of MODS.