住院慢性阻塞性肺疾病急性加重期患者合并低钠血症的相关危险因素分析

A study on the risk factors for hyponatremia in hospitalized acute exacerbation of chronic obstructive pulmonary disease patients

目的探讨住院慢性阻塞性肺疾病急性加重期(AECOPD)患者中合并低钠血症的独立危险因素。方法本回顾性横断面研究收集遂宁市人民医院老年医学科和绵阳市第三人民医院老年病科2019年1月—2021年12月的住院慢性阻塞性肺疾病急性加重期(AECOPD)患者327例。根据排除和入选标准,最后纳入患者215例,其中正常血钠AECOPD患者(NN-AECOPD)165例,AECOPD合并低钠血症患者(LN-AECOPD)50例。收集和记录患者一般资料、基础疾病、肺功能、血常规、PCT、CRP、血气分析和电解质数据。首先对数据进行单因素分析。然后对单因素分析有统计学差异的变量建立二元logistics回归模型。结果单因素分析显示两组患者的胸腔积液(PE)、社区获得性肺炎(CAP)和2型糖尿病的发生率,血淋巴细胞%、血清PCT和血清镁水平有显著统计学差异(均P<0.05)。然后,将有显著统计学差异的6个因子代入二元logistics回归方程后发现AECOPD患者中社区获得性肺炎(CAP)(R=5.109,P<0.001)与低钠血症独立相关。结论研究表明社区获得性肺炎是导致AECOPD患者低钠血症的重要原因。AECOPD合并社区获得性肺炎患者出现血电解质异常更加常见。同时若AECOPD患者合并低钠血症,我们应该考虑该患者合并社区获得性肺炎的可能。

Objective To explore the risk factors for hyponatremia in hospitalized Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients.Methods In this retrospective cross-sectional study,from January 2019 to June 2020,327 hospitalized AECOPD patients were enrolled.165 AECOPD with normal natrium(NN-AECOPD),and 50 AECOPD with hyponatremia(LN-AECOPD)were included.Demographic data,underlying diseases,lung function,blood routine,procalcitonin(PCT),C-reaction protein(CRP),and arterial blood gas(ABG)data were recorded.Binary logistics regression was performed to explore the independent risk factors for hyponatremia in AECOPD patients.Results The significant differences in 6 variables,including the rates of pleural effusion,community acquired pneumonia(CAP),and type 2 diabetes(T2DM),lymphocytes%,and serum magnesium(Mg 2+),were included in binary logistics regression.Subsequently,we identified that the rates of CAP(R=5.109,P<0.001)was independently associated with hyponatremia in hospitalized AECOPD patients.Conclusion The results indicate that CAP is an independent risk factor for hyponatremia in AECOPD patients.Then,hyponatremia is more common in AECOPD combined with CAP.Additionally,CAP should be seriously considered in AECOPD patients with hyponatremia.