Hypoalbuminemia in colorectal cancer prognosis:Nutritional marker or inflammatory surrogate?

Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.

Implications of preoperative hypoalbuminemia in colorectal surgery

Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient's chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.

Multiple chronic non-specific ulcer of small intestine characterized by anemia and hypoalbuminemia

A female patient with anemia and hypoalbuminemia was admitted to our hospital due to an over 20-year history of recurrent dizziness,fatigue and ankle edema.She was diagnosed as multiple chronic nonspecific ulcer of the small intestine characterized by non-specific histology and persistent gastrointestinal bleeding.

Association of post.treatment hypoalbuminemia and survival in Chinese patients with metastatic renal cell carcinoma

Background:Hypoalbuminemia adversely affects the clinical outcomes of various cancers.The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3-5 weeks after treatment in patients with metastatic renal cell carcinoma(mRCC) who received sorafenib or sunitinib as first-line treatment.Methods:In this single-center,retrospective study,we assessed the progression-free survival(PFS) and overall survival(OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment.PFS and OS were compared between patients with post-treatment hypoalbuminemia(post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level(albumin level≥36.4 g/L).The Memorial Sloan Kettering Cancer Center(MSKCC)risk model stratified mRCC patients into three risk categories.Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models.Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis.Results:The median PFS and OS of the 184 patients were 11 months(95%confidence interval[CI]9-12 months)and 23 months(95%CI 19-33 months),respectively.Patients with post-treatment hypoalbuminemia had significantly shorter median PFS(6 months[95%CI 5-7 months]) and OS(11 months[95%CI 9-15 months]) than patients who had normal post-treatment albumin levels(PFS:12 months[95%CI 11-16 months],P < 0.001;OS:31 months[95%CI24-42 months],P < 0.001),respectively.Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS(hazard ratio[HR],2.113;95%CI 1.390-3.212;P < 0.001) and OS(HR,2.388;95%CI 1.591-3.585;P < 0.001).Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS.The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS(c-index:0.68 and 0.73,respectively) compared with the basic MSKCC risk model(c-index:0.67 and 0.70,respectively).The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis(both P < 0.001).Conclusions:Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors.Additionally,integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

AIM:To determine the relationship between pre-operative hypoalbuminemia and the development of complications following rectal cancer surgery, as well as postoperative bowel function and hospital stay. METHODS:The medical records of 244 patients undergoing elective oncological resection for rectal adenocarcinoma at Siriraj Hospital during 2003 and 2006 were reviewed. The patients had pre-operative serum albumin assessment. Albumin less than 35 g/L was recognized as hypoalbuminemia. Postoperative outcomes, including mortality, complications, time to first bowel movement, time to first defecation, time to resumption of normal diet and length of hospital stay, were analyzed. RESULTS:The patients were 139 males (57%) and 105 females (43%) with mean age of 62 years. Fifty-six patients (23%) had hypoalbuminemia. Hypoalbuminemic patients had a significantly larger tumor size and lower body mass index compared with non-hypoalbuminemic patients (5.5 vs 4.3 cm;P < 0.001 and 21.9 vs 23.2 kg/m2;P = 0.02, respectively). Thirty day postoperative mortality was 1.2%. Overall complication rate was 25%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (37.5% vs 21.3%;P = 0.014). In univariate analysis, hypoalbuminemia and ASA status were two risk factors for postoperative complications. In multivariate analysis, hypoalbuminemia was the only significant risk factor (odds ratio 2.22,95% CI 1.17-4.23;P < 0.015). Hospitalization in hypoalbuminemic patients was significantly longer than that in non-hypoalbuminemic patients (13 vs 10 d, P = 0.034), but the parameters of postoperative bowel function were not significantly different between the two groups. CONCLUSION:Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following rectal cancer surgery.

Causal relationship between hypoalbuminemia and acute kidney injury

Our meta-analysis published in 2010 provided evidence that low levels of serum albumin(hypoalbuminemia) are a significant independent predictor of acute kidney injury(AKI) and death following AKI.Since then,a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence.This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk.Eligible studies published from September 2009 to December 2016 were sought in PubM ed(MEDLINE) and forty-three were retained,the great majority being retrospective observational cohort studies.These included a total of about 68000 subjects across a diverse range of settings,predominantly cardiac surgery and acute coronary interventions,infectious diseases,transplant surgery,and cancer.Appraisal of this latest data set served to conclusively corroborate and confirm our earlier hypothesis that lower serum albumin is an independent predictor both of AKI and death after AKI,across a range of clinical scenarios.The body of evidence indicates that hypoalbuminemia may causally contribute to development of AKI.Furthermore,administration of human albumin solution has the potential to prevent AKI;a randomized,controlled study provides evidence that correcting hypoalbuminemia may be renal-protective.Therefore,measurement of serum albumin to diagnose hypoalbuminemia may help identify high-risk patients who may benefit from treatment with exogenous human albumin.Multi-center,prospective,randomized,interventional studies are warranted,along with basic research to define the mechanisms through which albumin affords nephroprotection.

食管癌术后吻合口瘘的危险因素研究

目的探讨食管癌患者术后发生吻合口瘘的危险因素。方法回顾性分析107例食管癌手术患者的临床资料,将术后发生吻合口瘘的21例患者纳入观察组,将术后未发生吻合口瘘的86例患者纳入对照组,通过单因素分析和多因素Logistic回归分析明确食管癌术后发生吻合口瘘的危险因素。结果单因素分析结果显示,年龄、低蛋白血症、糖尿病史、术前新辅助治疗、吻合部位均与食管癌术后吻合口瘘有关(P<0.05);多因素Logistic回归分析显示,术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素(OR=5.392,95%CI:1.335~30.382,P=0.020)。结论术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素,对于术前合并其他系统疾病尤其是糖尿病、低蛋白血症的高危患者,应做好充分的术前准备。

四肢创伤骨折病人术后低蛋白血症的危险因素分析及风险预测模型的构建

目的 探讨四肢创伤骨折病人术后低蛋白血症的危险因素,并构建四肢创伤骨折病人术后低蛋白血症的风险预测模型。方法 选取2018年3月至2022年8月池州市人民医院手术治疗的226例四肢创伤骨折病人作为研究对象。应用Lasso分析筛选四肢创伤骨折病人术后低蛋白血症的预测因素,应用logistic回归分析筛选四肢创伤骨折病人术后低蛋白血症的危险因素,应用R软件构建四肢创伤骨折病人术后低蛋白血症的列线图模型,并对四肢创伤骨折病人术后低蛋白血症的列线图模型进行验证。结果 logistic回归分析结果显示,女性、年龄≥65岁、术中出血量≥300 mL、胃肠功能损伤、肺部感染、术前白蛋白<35 g/L、衰弱、输注胶体液及蛋白等是四肢创伤骨折病人术后低蛋白血症的危险因素(P<0.05)。四肢创伤骨折病人术后低蛋白血症的列线图模型的校正曲线显示预测值与实际值的拟合度较好;模型的AUC是0.84[95%CI:(0.80,0.87)];决策曲线显示阈值概率在2%~75%范围内时,应用该列线图预测四肢创伤骨折病人术后低蛋白血症净获益值较高。结论 女性、年龄≥65岁、术中出血量≥300 mL、胃肠功能损伤、肺部感染、术前白蛋白<35 g/L、衰弱、输注胶体液及蛋白等是四肢创伤骨折病人术后低蛋白血症的危险因素,本研究基于以上8项危险因素构建的列线图能够对四肢创伤骨折病人术后低蛋白血症的防治工作起到帮助作用。

胃肠道肿瘤患者术后低蛋白血症的相关危险因素分析和预测模型建立

目的:旨在筛选胃肠道肿瘤术后低蛋白血症的围术期相关危险因素,并建立相应预测模型。方法:回顾性分析2022年12月至2023年6月在我院行胃肠道肿瘤根治术的244例患者临床资料,运用Logistic回归分析对术后低蛋白血症的相关因素进行单因素和多因素分析,筛选出独立危险因素;并建立Nomogram预测模型,评估其预测价值。结果:研究结果显示,共计125例患者术后出现低蛋白血症,占比54.8%。多因素Logistic回归分析显示:术前白蛋白水平(OR 0.70,P<0.01)、BMI(OR 0.79,P<0.01),术中激素(OR 0.92,P<0.01)、白蛋白使用量(OR 0.72,P<0.01),术毕血糖(OR 1.54,P<0.01)和复合硬膜外麻醉(OR 0.38,P<0.05)为术后低蛋白血症发生的独立危险因素。预测模型ROC曲线下面积为0.848(95%CI 0.800~0.896),预测价值较好。结论:术前白蛋白水平、BMI,术中激素、术中白蛋白使用量,术毕血糖和复合硬膜外麻醉是术后低蛋白血症发生的独立危险因素,基于上述变量的Nomogram列线图预测模型具有较高的预测效能,可为临床决策提供有效参考。

Preoperative Corticosteroid Usage and Hypoalbuminemia Increase Occurrence of Short-term Postoperative Complications in Chinese Patients with Ulcerative Colitis

Background： Clarifying the risk factors for postoperative complications and taking measures to minimize these complications will improve the outcomes in patients with ulcerative colitis （UC）.This study aimed to systemically explore the risk factors for short-term postoperative complications in Chinese UC patients undergoing ileocolorectal surgery.Methods： Forty-nine UC patients undergoing proctocolectomy or ileostomy were retrospectively enrolled.Univariate and multivariate logistic regression analyses were conducted to reveal the risk factors among the clinical, laboratory, and surgical variables as well as preoperative medications.Results： Twenty-two （44.9%） patients who suffered from at least one short-term postoperative event had more severe hypoalbuminemia （P =0.007） and an increased prevalence of preoperative corticosteroid usage （prednisone more than 20 mg daily or equivalent） for more than 6 weeks （59.1% vs.25.9%, P =0.023） compared with patients without short-term postoperative complications.Based on the multivariate logistic regression analysis, the odds ratio （95% confidence interval） values of these two risk factors were 1.756 （0.889-3.470, P =0.105） and 3.233 （0.916-11.406, P =0.068）, respectively.In 32 severe UC patients, prolonged preoperative hospital stay worsened the short-term postoperative outcomes.Conclusions： Preoperative corticosteroids usage and hypoalbuminemia worsened the short-term outcomes following ileocolorectal surgery in Chinese UC patients.

Is correction of severe hypoalbuminemia necessary in the critically ill？

The rationale for using albumin in the critically ill intensive care unit （ICU） patient showing hypoalbuminemia is to increase colloid oncotic pressure （COP） to prevent extravasation of fluid from the intra- to the extravascular space. Correction of low albumin plasma levels is also justified by the role of albumin for binding and transportation of drugs and for its possibly beneficial role as an oxygen radical scavenger.

应用托伐普坦治疗糖尿病肾病综合征所致顽固性水肿个案分析

糖尿病肾病综合征(diabeticnephropathysyndrome,DNS)是一种非免疫因素介导的继发性肾病综合征。由于其发病为非免疫因素介导,此类患者应用激素治疗无效,导致其引起的水肿在治疗上更加依赖利尿剂。新型利尿剂托伐普坦是一种选择性血管加压素V2受体拮抗剂,其发挥作用不依赖于白蛋白,目前主要用于减轻肝硬化、心力衰竭、抗利尿激素分泌异常综合征等导致的水肿,还可用于常染色体显性多囊肾病的辅助治疗,但在DNS患者中的应用较少。本文通过分享应用托伐普坦治疗1例顽固性水肿的DNS患者的经过,探讨托伐普坦治疗DNS患者的效果、安全性及未来前景。

重度子痫前期并发心功能不全的危险因素分析

目的探究重度子痫前期(severe preeclampsia,sPE)出现心功能不全相关的危险因素。方法选取2020年1月至2023年9月于温州市中心医院住院的sPE并发心功能不全的患者32例作为实验组,并随机选取同时期心功能正常的sPE患者75例作为对照组。比较两组患者的一般资料和实验室指标的差异,采用二元Logistic回归分析探讨sPE出现心功能不全的危险因素。结果实验组患者出现呼吸衰竭、血管内溶血-肝酶升高-低血小板、感染的例数高于对照组,差异有统计学意义(P<0.05)。对照组发生新生儿窒息、新生儿转重症监护的例数高于实验组,差异有统计学意义(P<0.05)。两组患者的孕前体质量指数、孕期体质量增幅、血钙、白蛋白、血红蛋白、双胎、感染差异有统计学意义(P<0.05),二元Logistic回顾分析结果显示,孕前体质量指数增加、孕期体质量增幅≥20kg、低血钙、低白蛋白、中度贫血、孕期血压增加是sPE出现心功能不全的危险因素。结论孕期应积极控制血压、补钙、补铁、补充白蛋白、控制体质量;对sPE患者增加血钙、白蛋白、血红蛋白、血压相关指标监测的频率,积极控制血压、解痉、预防感染可减少sPE患者心功能不全的发生。

冠状动脉旁路移植术后低清蛋白血症危险因素与预后

目的探讨冠状动脉旁路移植术(CABG)后低清蛋白血症的危险因素及临床预后。方法回顾分析CABG病人483例,定义术后第1天血清清蛋白(ALB)水平较术前下降的差值为△ALB,将△ALB≤7 g/L病人97例归为A组、7 g/L<△ALB≤15 g/L病人298例归为B组、△ALB>15 g/L病人88例归为C组。比较3组病人术前、术中、术后相关资料及术后随访36个月主要不良心血管事件(MACE)发生情况。结果C组合并高尿酸血症的病人数及左室射血分数<40%的病人数高于A、B两组,差异有统计学意义(χ^(2)=6.802~6.857,P<0.05);B、C两组中有介入治疗(PCI)史的病人数高于A组,差异有统计学意义(χ^(2)=8.193,P<0.05);C组术后在ICU停留时间>72 h、CABG当天引流>400 mL、大量失血、输注红细胞、输注血浆、肾损伤等病人占比明显高于A、B两组,差异有统计学意义(χ^(2)=6.741~39.287,P<0.05);C组术后MACE事件发生率高于A、B两组,差异有统计学意义(χ^(2)=8.205,P<0.05)。Cox回归分析中校正多种混杂因素后,病人术前有PCI史(OR=1.670,95%CI=1.091~2.556,P=0.018)及左室射血分数<40%(OR=4.468,95%CI=2.304~8.665,P<0.001)是术后ALB水平减低的独立危险因素,CABG后第1天ALB水平较术前下降程度7 g/L<△ALB≤15 g/L(OR=2.784,95%CI=1.190~6.516,P=0.018)和△ALB>15 g/L(OR=3.487,95%CI=1.373~8.853,P=0.009)是远期MACE的独立预测因素。结论PCI史及左室射血分数<40%是CABG后ALB水平减低的独立危险因素,术后第1天ALB水平较术前下降>7 g/L是CABG预后的预测因素。

腹腔镜结直肠癌根治术后动力性肠梗阻发生情况及高危因素分析

目的探讨结直肠癌患者腹腔镜下根治术后动力性肠梗阻发生现状及影响因素。方法选取2020年2月-2023年4月我院收治的80例腹腔镜下结直肠癌根治术患者,根据术后是否发生动力性肠梗阻分为两组。收集患者性别、年龄、体重指数、文化程度、肿瘤位置、TNM分期、分化程度、术前是否有肠梗阻、腹部手术史、合并贫血、淋巴结转移、低蛋白血症、肿瘤直径、手术时间、吸烟酗酒史等资料。对一般资料进行单因素分析,再对有统计学差异因素的进行多因素Logistic回归分析。结果80例腹腔镜下结直肠癌根治术患者,18例动力性肠梗阻,发生率22.50%;单因素分析显示,两组TNM分期、术前是否有肠梗阻、腹部手术史、术前是否合并贫血、是否淋巴结转移、术前是否有低蛋白血症比较,差异有统计学意义(χ^(2)=18.148、7.681、8.119、10.904、9.395,P=0.000、0.003、0.006、0.0.05、0.001);Logistic回归分析TNM分期为Ⅲ期、术前有肠梗阻、有腹部手术史等是影响腹腔镜下结直肠癌根治术后动力性肠梗阻发生的独立危险因素(P<0.05且OR>1)。结论直肠癌患者腹腔镜根治术后动力性肠梗阻发生与TNM分期为Ⅲ期、术前有肠梗阻等有关,及时制定针对性预防措施,从而减少动力性肠梗阻。

三皇穴合当归芍药散治疗低蛋白血症临床经验总结

低蛋白血症是临床中的常见病,近年来其发病率较前升高。低蛋白血症的病因和发病机制较为复杂,老年人群发生低蛋白血症的风险更高,这可能与老年衰弱、消化系统器官功能衰退等因素有关,患者常出现食物摄入不足、食欲不佳、消化不良等表现,进而造成营养物质的吸收障碍,继而引发低蛋白血症。本病不仅影响患者的生活质量,而且不利于患者身体恢复,对患者的身体和心理产生不良影响。目前现代医学治疗本病主要着眼于临床症状及化验指标,以对症支持治疗为主。笔者在多年临证工作中,善于从中医整体观念和辨证论治的角度出发诊治疾病,认为本病的发生与肺、脾、肾、三焦关系密切,其病因为脾虚湿盛、血瘀水停。在治疗上应着眼于整体,从“健脾”“祛湿”与“活血利水”的角度入手。基于此,笔者采用针药结合的方法治疗低蛋白血症,在黄煌教授“方证相应”的理论基础上,采用了中医传统经典方当归芍药散,而且结合针刺治疗,取方当归芍药散结合针刺三皇穴治疗低蛋白血症,治疗效果显著,不良反应少,患者满意度高。文章为今后治疗此类疾病提供了针药结合的方法,也为中药及中医适宜技术在该疾病的治疗方面提供了新思路,值得在临床中进一步应用。

Association between serum albumin levels and disease severity in adult patients with dengue: A 7-year retrospective cohort study in China's Mainland

Objective:To identify the association between serum albumin levels and disease severity among adult patients with dengue in China's Mainland.Methods:This retrospective cohort study analyzed the data of adult patients(aged≥18 years)hospitalized with laboratory-confirmed dengue in a tertiary center for infectious diseases from 2013 to 2019 in China's Mainland.Serum albumin levels were estimated and compared between patients with severe dengue and non-severe dengue.Additionally,the association between serum albumin levels and severe dengue was evaluated using a generalized linear model[relative risks(RR)].Multivariate logistic regression analysis was performed to identify the potential predictors of severe dengue.Results:Overall,1568 patients were included in this study.Of these patients,34(2.17%)developed severe dengue.The median serum albumin levels were significantly lower in patients with severe dengue than that in those with non-severe dengue(33 g/L vs.37 g/L,P<0.001).After adjustment for age,sex,and comorbidities,hypoalbuminemia(RR 4.877,95%CI 2.193-11.461,P<0.001)was found to be a predictor of severe dengue.Serum albumin levels(OR 1.303,95%CI 1.161-1.462,P<0.001)and age(OR 1.038,95%CI 1.017-1.061,P<0.001)were significant risk factors for severe dengue.The area under the curve for serum albumin levels to distinguish severe dengue was 0.787.Conclusions:Lower serum albumin levels were significantly associated with disease severity in adult patients with dengue.Hypoalbuminemia on admission resulted in at least a four-fold increased risk of severe dengue.

妇科患者术后低蛋白血症的影响因素分析

目的 探讨妇科患者术后低蛋白血症的影响因素。方法 回顾性分析我科2021年8月至2022年2月收治的186例妇科手术患者的临床资料,探讨妇科手术患者术后低蛋白血症的发生情况及影响因素。结果 妇科患者术后低蛋白血症的发生率为25.3%。多因素Logistic回归分析显示:肿瘤良恶性、术中出血、术前清蛋白水平是妇科患者术后发生低蛋白血症的独立影响因素(P<0.05)。结论 术前对营养不良患者及早干预、营养支持,术中细致操作、减少出血,有望降低术后低蛋白血症的发生率,改善妇科患者的预后。

基于列线图模型对进展期胃窦癌术前低蛋白高危患者的识别

目的:探讨胃窦癌根治术前低白蛋白血症发生的高危因素以及对预后的影响。方法:选择2008年6月至2015年6月福建省肿瘤医院收治的行手术治疗胃窦癌患者共497例,按术前血清白蛋白水平分为低白蛋白组(<35 g/L,194例)与正常白蛋白组(≥35 g/L,303例),分析根治术前低白蛋白血症发生的高危因素及对预后的影响。结果:影响根治术前低白蛋白血症的单因素研究发现,在年龄、肿瘤大小、分化程度、肿瘤T分期、TNM分期上,低白蛋白组与正常白蛋白组存在统计学差异(P<0.05);多因素研究发现,年龄、肿瘤大小、肿瘤TNM分期是术前低白蛋白血症发生的独立危险因素,并据此建立列线图风险预测模型;低白蛋白组1年、3年、5年生存率分别为96.3%、85.7%、78.7%,正常白蛋白组1年、3年、5年生存率分别为94.1%、76.0%、62.9%,差异有统计学意义(P<0.001)。胃窦癌患者预后单因素及多因素分析结果显示,年龄、T分期、TNM分期、术前白蛋白是患者的独立预后因素(P<0.05)。结论:对于胃窦癌患者,年龄、肿瘤大小及肿瘤TNM分期是术前低白蛋白血症发生的独立危险因素,术前低白蛋白血症是胃窦癌患者不良预后的提示,对该类患者应加强识别及干预措施。

支气管扩张症病人继发感染的相关影响因素及其干预措施分析

目的:探讨支气管扩张症病人继发感染的相关影响因素及其干预措施。方法:采用便利抽样法选取2020年3月—2022年2月就诊于赣州市人民医院的96例支气管扩张症病人为研究对象,收集、统计病人资料,分析支气管扩张症继发感染的相关影响因素。结果:96例支气管扩张症病人中继发感染36例(37.50%),未继发感染60例(62.50%);单因素分析结果显示,年龄、吸烟史、合并糖尿病、合并肺部基础疾病、长期使用糖皮质激素、抗生素使用时间、低蛋白血症与支气管扩张症病人继发感染有关(P<0.05);Logistic回归分析结果显示,年龄≥60岁(OR=4.000)、有吸烟史(OR=7.156)、合并糖尿病(OR=2.625)、合并肺部基础疾病(OR=4.904)、长期使用糖皮质激素(OR=4.221)、抗生素使用时间≥2周(OR=9.667)、低蛋白血症(OR=6.500)是支气管扩张症病人继发感染的高危因素(P<0.05)。结论:支气管扩张症病人继发感染与年龄、吸烟史、合并糖尿病、长期使用糖皮质激素、合并肺部基础疾病、抗生素使用时间、低蛋白血症有关。临床应据此制订干预措施,以预防支气管扩张症病人继发感染的发生。