脓毒症患者引发急性肺损伤危险因素分析

Analysis on risk factors of acute lung injury in patients with sepsis

目的探讨脓毒症引发急性肺损伤预后的危险因素。方法收集2017年1月至2019年12月我科收治256例脓毒症患者,分为脓毒症引发急性肺损伤(ALI)组(n=89)和脓毒症不引发ALI组(n=167),统计两组一般资料、临床资料,感染部位,感染病原等,将两组各项指标进行比较,之后选择有意义的指标(P<0.05)进行多因素非条件的Logistic回归分析。结果两组年龄、BMI、吸烟、酗酒、体温、血压、呼吸、心率等比较,差异无统计学意义(P>0.05);脓毒症引发ALI组的指标:基础病、氧合指数、SOFA评分、APACHEⅡ评分、鲍曼不动杆菌及真菌的发生率、肺部及腹部感染发生率明显高于脓毒症不引发ALI组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,肺部感染、SOFA评分、APACHEⅡ评分及氧合指数是脓毒症并发急性肺损伤的危险因素(P<0.05)。结论肺部感染、SOFA评分、APACHEⅡ评分及氧合指数是脓毒症引发急性肺损伤的危险因素,临床上应重视。

Objective To explore the prognostic risk factors of acute lung injury induced by sepsis.Methods From January 2017 to December 2019,256 patients with sepsis who were admitted to our department were selected and divided into the sepsis-induced acute lung injury(ALI)group(n=89)and non-sepsis-induced ALI group(n=167).General data,clinical data,infection sites,and infectious pathogens were statistically analyzed.The indicators were compared between the two groups,and the significant indicators(P<0.05)were selected for multivariate unconditional Logistic regression analysis.Results There was no statistically significant difference between the two groups in age,BMI,smoking,alcohol abuse,body temperature,blood pressure,respiration,and heart rate(P>0.05);the indicators of sepsis-induced ALI group:underlying disease,oxygenation index,SOFA score,APACHEⅡscore,incidence rate of Acinetobacter baumannii and fungi,the incidence rate of lung and abdominal infections were significantly higher than those in non-sepsis-induced ALI group,and the differences were significant(P<0.05);multivariate Logistic regression analysis showed that lung infection,SOFA score,APACHEⅡscore and oxygenation index were risk factors for sepsis complicated by acute lung injury(P<0.05).Conclusion Pulmonary infection,SOFA score,APACHEⅡscore,and oxygenation index are risk factors for acute lung injury caused by sepsis,and clinical attention should be paid.