老年慢性阻塞性肺疾病急性加重相关临床因素分析

Analysis of Related Clinical Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Diseases in Elderly Patients

目的 了解老年慢性阻塞性肺疾病（COPD）急性加重的临床因素.方法 抽取2011年1月至2013年10月保定市第四医院216例COPD急性加重为病例组,选取同期住院好转出院3个月以上COPD稳定期患者216例作为对照组.均进行螺旋CT肺动脉造影和双下肢静脉超声、D-二聚体、肺功能、降钙素、C反应蛋白、体质指数、血脂等临床指标检测.结果 老年COPD急性加重相关影响因素有白细胞（OR =3.601,95％CI 1.739～6.527）、降钙素原（OR=2.163,95％ CI1.249 ～5.032）、体质指数（OR=2.962,95％ CI1.504 ～ 5.408）、D-二聚体（OR=1.624,95％ CI1.122～4.635）、第1秒用力呼气量/用力肺活量（OR=1.538,95％ CI1.156 ～3.851）.结论 感染、体质指数、肺功能降低、中低危肺栓塞因素是COPD急性加重的相关临床因素.

Objectives To learn the clinical factors of acute exacerbation of chronic obstructive pulmonary disease （COPD） in elderly patients. Methods Total of 216 AECOPD patients were extracted from Baoding Fourth Hospital between Jan. 2011 and Oct. 2013 were included as case group, another 216 hospitalized patients who were discharged because of improvement during the same period were included as control group. Spiral CT pulmonary angiography and double lower limbs vein ultrasonic, D-dimer, pulmonary func- tion, calcitonin, C reactive protein,the body mass index, blood lipids and other clinical indicators of the two groups were obtained. Results Aggravating factors of senile acute exacerbation of COPD mainly included white blood cells（OR = 3. 601,95% CI 1. 739-6. 527 ）, calcitonin （ OR = 2. 163,95% CI 1. 249-5. 032）, body mass index（ OR = 2. 962,95 % CI 1. 504-5. 408 ）, D-dimer（ OR = 1. 624,95% CI 1. 122-4. 635 ） ,forced expiratory volumein in one second/forced vital capacity（ OR = 1. 538,95% CI 1. 156-3. 851 ）. Conclusion Infection, body mass index, reduced lung function, middle and low-risk pulmonary embolism are associated with acute exacerbation of COPD.