摘要
目的:探讨重症肺炎(SP)患者死亡的危险因素。方法:回顾性分析我院2014年8月至2016年12月收治的SP患者,记录所有SP患者的一般资料、主要临床指标、病原微生物分布、机械通气时间、入科2 h内的降钙素原(PCT)值、24 h内最差急性生理及慢性健康(APACHEⅡ)评分、最低PaO2/FiO2和最高乳酸值。结果:88例SP患者死亡36例,死亡率40.91%(36/88)。影响SP患者死亡的单因素有年龄、pH值、脏器损害、氧合指数、肺炎克雷伯菌感染、PCT、乳酸、APACHEⅡ评分和机械通气时间(P<0.05),性别、SP类型、体重指数、抽烟、喝酒、基础疾病、脉搏、呼吸、体温、血压、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、尿素氮、内生肌酐清除率、血糖、高密度脂蛋白、低密度脂蛋白和致病菌分布对SP患者死亡无影响(P>0.05)。多因素Logistic回归分析,年龄、脏器损害、氧合指数和乳酸是SP患者死亡的影响因素(P<0.05)。结论:高龄、合并脏器功能损害、低氧合指数和乳酸可能是SP患者死亡的危险因素。
Objective:To investigate the risk factors of patients with severe pneumonia(SP).Methods:A retrospective analysis of SP patients admitted to our hospital from August 2014 to December 2016 was performed and the general information,main clinical indicators,pathogen infection distribution,mechanical ventilation time,procalcitonin(PCT)value within 2 hours of admission,worst scores of acute physiology and chronic health within 24 h by acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ),lowest PaO2/FiO2,and highest lactic acid value of all SP patients were recorded.Results:Among the 88 SP patients,36 patients died,52 patients survived,and the mortality rate was 40.91%(36/88).The single factors affecting the death of SP patients were age,pH,organ damage,oxygenation index,Klebsiella pneumoniae infection,PCT,lactic acid,APACHEⅡand mechanical ventilation time(P<0.05);gender,SP type,and body weight index,smoking,drinking,underlying disease,pulse,respiration,body temperature,blood pressure,aspartate aminotransferase,alanine aminotransferase,urea nitrogen,endogenous creatinine clearance,blood sugar,high density lipid,the distribution of protein,low-density lipoprotein and pathogenic bacteria had no effect on the death of SP patients(P>0.05).Multivariate logistic regression analysis showed that age,organ damage,oxygenation index and lactic acid were the risk factors of SP patients(P<0.05).Conclusion:Advanced age,combined organ dysfunctions,higher hypoxia index and lactic acid may be risk factors for death of SP patients.
作者
王春亚
郭蕾
王小闯
吴媛
WANG Chunya;GUO Lei;WANG Xiaochuang;WU Yuan(Dept.of Critic Care Medicine,The Second Affiliated Hospital of Xi'an Jiaotong University Medical College,Xi'an 710004,Shaanxi,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第1期110-113,共4页
Medical Journal of Wuhan University
基金
陕西省重点研发计划资助项目(编号:2018SF-206).
关键词
重症肺炎
年龄
脏器损害
氧合指数
Severe Pneumonia
Age
Organ Dysfunction
Hypoxia Index
