慢性阻塞性肺疾病并发急性呼吸衰竭的危险因素分析

Risk factors of chronic obstructive pulmonary disease complicated with acute respiratory failure

目的:探究引起慢性阻塞性肺疾病并发急性呼吸衰竭的危险因素,为慢性阻塞性肺疾病的临床治疗提供一定参考。方法:选择2018年1月-2019年1月在我院进行慢性阻塞性肺疾病治疗65例患者为研究对象,将其中26例并发急性呼吸衰竭患者分为观察组,39例未并发急性呼吸衰竭患者分为对照组;比较两组患者体质指数(BMI)、血氧分压(PaO2)水平、慢性阻塞性肺疾病分级、急性发作次数、尿酸水平、白蛋白水平、二氧化碳分压(PaCO2)水平、糖皮质激素使用率、酸碱平衡紊乱率、医院感染率等各项临床指标水平,并将上述因素进行单因素Logistic回归分析。结果:两组BMI、PaO2水平、慢性阻塞性肺疾病分级比较,差异无统计学意义(P>0.05);两组急性发作次数、尿酸水平、白蛋白水平、PaCO2水平、糖皮质激素使用率、酸碱平衡紊乱率、医院感染率比较,差异有统计学意义(P<0.05);单因素Logistic回归分析,尿酸水平、白蛋白水平、酸碱平衡紊乱、医院感染及未使用糖皮质激素是慢性阻塞性肺疾病并发急性呼吸衰竭的主要危险因素。结论:慢性阻塞性肺疾病并发急性呼吸衰竭的主要危险因素是尿酸水平、白蛋白水平、酸碱平衡紊乱、医院感染及未使用糖皮质激素,在患者入院治疗时应对危险因素进行严格控制,降低患者死亡率。

Objective:To explore the risk factors of chronic obstructive pulmonary disease complicated with acute respiratory failure.It provides certain reference for the clinical treatment of chronic obstructive pulmonary disease.Methods:Sixty-five patients who received treatment for chronic obstructive pulmonary disease in our hospital from January 2018 to January 2019 were selected as study data.Among them,26 patients with acute respiratory failure were divided into observation group and 39 patients without acute respiratory failure were divided into control group.The BMI index,PaO2 level,copd grade,number of acute episodes,uric acid level,albumin level,PaCO2 level,glucocorticoid utilization rate,acid-base balance disorder rate,nosocomial infection rate and other clinical indicators were compared between the two groups,and the above factors were analyzed by single-factor Logistic regression.Results:BMI index,PaO2 level and copd grade were compared between the two groups,and the differences were not statistically significant(P>0.05).There were significant differences in the frequency of acute attack,uric acid level,albumin level,PaCO2 level,glucocorticoid use rate,acid-base balance disorder rate and hospital infection rate between the two groups(P<0.05).Single factor Logistic regression analysis showed that uric acid level,albumin level,acid-base balance disorder,hospital infection and no use of glucocorticoid were the main risk factors of chronic obstructive pulmonary disease complicated with acute respiratory failure.Conclusion:The main risk factors of chronic obstructive pulmonary disease complicated with acute respiratory failure are uric acid level,albumin level,acid-base balance disorder,hospital infection and no use of glucocorticoids,when patients are admitted to hospital,we should strictly control the risk factors to reduce the mortality.