COPD急性加重期患者住院天数及血气分析指标纠正效果的影响因素分析

Study on influencing factors of the length of hospital stay and correction effect of blood gas analysis index in patients with acute exacerbation of chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者住院天数及血气分析纠正效果的影响因素。方法:回顾性分析2018—2021年在贵港市人民医院和梧州市工人医院住院治疗的429例AECOPD患者的临床资料,收集患者1年前空气质量暴露数据,用二分类Logistic回归分析住院天数、血气分析纠正效果的影响因素。结果:低氯(OR=0.071)、高肌酐(OR=0.148)、肺气肿(OR=0.131)、主动脉或冠状动脉硬化(OR=0.165)是二氧化碳分压(PaCO_(2))纠正效果的影响因素(均P<0.05);高血压(OR=0.266)、肺部感染(OR=3.645)、肺部纤维化(OR=5.419)是pH纠正效果的影响因素(均P<0.05);二氧化硫(SO_(2))(OR=0.343)是乳酸纠正效果的影响因素(P<0.05);第1秒用力呼气容积(FEV1)预计值(OR=0.005)是红细胞压积纠正效果的影响因素(P<0.05);低碳酸氢盐(OR=0.477)是住院天数的影响因素(P<0.05)。结论:通过临床资料及空气质量数据的收集与分析,发现一些影响COPD住院时间和血气分析纠正效果的因素。

Objective:To explore the risk factors affecting the length of hospital stay and correction effect of blood gas analysis in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)(AECOPD).Methods:The clinical data of 429 patients with AECOPD in Guigang People's Hospital and Wuzhou Workers'Hospital from 2018 to 2021 were retrospectively analyzed,and the air quality exposure data of patients one year ago were collected.Binary Logistic regression was used to explore the influencing factors of the length of hospital stay and correction effect of blood gas analysis.Results:Low chlorine(OR=0.071),high creatinine(OR=0.148),emphysema(OR=0.131),aortic or coronary atherosclerosis(OR=0.165)were the factors affecting the correction effect of partial pressure of carbon dioxide(PaCO_(2))(all P<0.05).Hypertension(OR=0.266),pulmonary infection(OR=3.645)and pulmonary fibrosis(OR=5.419)were the factors affecting the pH correction effect(all P<0.05).Sulfur dioxide(SO_(2))(OR=0.343)was the factor affecting the correction effect of lactate(P<0.05);the predicted forced expiratory volume(FEV1)(OR=0.005)in the first second was the factor affecting the correction effect of hematocrit(P<0.05);low bicarbonate(OR=0.477)were the factors affecting the length of hospital stay(P<0.05).Conclusions:Through the collection and analysis of clinical data and air quality data,we found some factors affecting the length of hospital stay and correction effect of blood gas analysis in COPD.