慢性阻塞性肺疾病合并社区获得性肺炎的临床比较研究

Comparison between community -acquired pneumonia patients with/without chronic obstructive pulmonary disease

目的比较合并和未合并慢性阻塞性肺疾病（COPD）的社区获得性肺炎（CAP）患者的临床特点、治疗反应和预后的异同。方法选择58例合并COPD和67例未合并COPD的CAP患者为研究对象，收集2组患者的一般临床资料、实验室检查结果、影像学资料、初始治疗效果和30天病死率。结果与未合并COPD的CAP患者相比，合并COPD的CAP年龄大、重症肺炎患者多；胸部影像学多叶段浸润、胸腔积液比例明显增多，差异有统计学意义（P〈0．05）。合并COPD的CAP患者初始治疗失败率、30天内病死率明显高于未合并COPD的CAP患者。结论合并COPD的CAP患者较未合并COPD的CAP患者病情重、初始治疗效果差、30天病死率高。

Objective To compare the clinical characteristics, therapeutic reactions, and prognosis of community - acquired pneumonia （CAP） patients with/without chronic obstructive pulmonary disease （COPD）. Methods A total of 58 CAP patients with COPD and 67 CAP patients without COPD were enrolled in the current study, whose clinical data, laboratory data, radiographic images, initial treatment response and 30 - day mortality were collected and retrospectively reviewed. Results Compared with patients suffering from CAP alone, those with COPD and CAP were older, with more severe cases, and manifested more obvious pleural effusion and multilobar involvement in radiologie images （ P 〈 0.05 ）. There was a significantly higher rate of initial treatment failure and 30 - day mortality rate among CAP patients with COPD than non - COPD participants. Conclusion CAP patients with COPD present more severe pneumonia and poor efficacy of initial therapy efficacy, and a higher 30 - day mortality rate compared with non - COPD patients.