急性一氧化碳中毒后发生急性肺损伤的相关危险因素分析

The clinical risk factors of acute lung injury after acute cabon oxygen poison

目的探讨急性一氧化碳中毒后发生急性肺损伤的相关危险因素。方法整理2007年1月至2009年12月于哈尔滨市第一医院就诊,诊断为"急性一氧化碳中毒"患者180例的临床资料,分为发生急性肺损伤组和未发生急性肺损伤组,收集了指标:年龄、性别、中毒媒介、有无误吸、中毒程度、入院时动脉血氧分压、动脉血乳酸;入院时血常规白细胞计数;入院时生化肌酸激酶浓度。进行了单因素分析、Logistic回归分析,筛选出急性一氧化碳中毒后发生急性肺损伤的相关危险因素。结果该研究总例数180例,男86例,女94例,年龄(42.90±18.99)岁。发生急性肺损伤患者38例,患病率21.11%。通过单因素分析显示年龄、性别、入院时血氧分压发生急性肺损伤组和未发生急性肺损伤组比较差异无统计学意义(P>0.05)。有无误吸;中毒媒介;中毒程度;昏迷时间;入院时动脉血乳酸、入院时血常规白细胞计数、入院时生化肌酸激酶浓度,两组比较差异有统计学意义(P<0.05)。对单因素分析差异有统计学意义的指标进行二项logistic回归分析,显示误吸、重度中毒、煤烟中毒、血动脉乳酸升高的OR值分别为3.06、4.80、2.00、1.20;均是急性一氧化碳中毒后发生急性急性肺损伤的相关危险因素(P<0.05)。结论误吸、重度中毒、煤烟中毒、血乳酸升高均是急性一氧化碳中毒后发生急性急性肺损伤的危险因素。

Objective To discuss the relative risk factors of acute lung injury developing after acute carbon monoxide poisioning. Methods During January,2007-December 2009,180 cases of clinical of acute carbon monoxide poisoning diagnosed by the First Hospital of Harbin,were analyzed. With the statistical analysis,the acute lung injury＇s risk factors which caused carbon monoxide poisoning were determined. Results In this study,the total number of 180 cases,includes male 86,female 94,the average age was（42. 90 ±18. 99） years old. In this research,the occurrence of 38 patients are lung injury,the incidence rate was 21. 11%. There was no significant difference between partial pressure of oxygen blast lung injury group and not occurring group in terms of age,gender（P〉 0. 05）. There contain the significant statistic value when consider the factors like aspiration,poisoning media,degree of poisoning,coma duration,duration of admission,blood lactic acid,white blood cell count,serum ck. Singular factor analysis of which can cause significant standard showed that aspiration,severe poisoning,soot poisoning,lactic acid was 3. 06,4. 80,2. 00,1. 20 respectively.They are the dangerous factors,which is caused by acute carbon monoxide poisoning,can cause lung injury. Conclusion The risk factors： aspiration,severe poisoning,soot poisoning and lactic acid,which is caused by acute carbon monoxide poisoning can cause lung injury.