慢性阻塞性肺疾病急性加重患者并发肺部感染的相关因素分析

Analysis of related factors of pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病急性加重(AECOPD)患者并发肺部感染的相关因素。方法回顾性分析我院137例AECOPD患者的临床资料,对可能导致AECOPD患者并发肺部感染的相关因素进行单因素分析和多因素Logistic回归分析。结果 137例AECOPD患者中,58例患者并发肺部感染,发生率为42.34%,死亡率为10.34%。单因素分析结果显示,频繁更换抗生素、抗生素使用时间、长期使用糖皮质激素、侵入性操作、合并糖尿病及低蛋白血症与AECOPD患者并发肺部感染显著相关(P<0.05)。多因素Logistic回归分析显示,抗生素使用时间、长期使用糖皮质激素及合并低蛋白血症是AECOPD患者并发肺部感染的独立危险因素(P<0.05)。结论导致AECOPD患者并发肺部感染的独立危险因素较多,规范化使用抗生素及糖皮质激素,加强营养支持治疗是重要的预防措施。

Objective To analyze the related factors of pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 137 patients with AECOPD were retrospectively analyzed.Univariate analysis and multivariate Logistic regression analysis were performed on factors associated with pulmonary infection in patients with AECOPD.Results In the 137 AECOPD patients,58 patients developed pulmonary infection with an incidence of 42.34%and a mortality rate of 10.34%.The univariate analysis showed that frequent replacement of antibiotics,antibiotic use time,long-term use of glucocorticoids,invasive procedures,complicated diabetes and hypoproteinemia were significantly associated with pulmonary infection in patients with AECOPD(P<0.05).The multivariate Logistic regression analysis showed that antibiotic use time,long-term use of glucocorticoids and with hypoproteinemia were the independent risk factors for pulmonary infection in patients with AECOPD(P<0.05).Conclusion There are many independent risk factors for pulmonary infection in patients with AECOPD,and standardized use of antibiotics and glucocorticoids and strengthening nutritional support therapy are important preventive measures.