肺结核并发多器官功能障碍综合征53例临床分析

目的探讨影响肺结核并发MODS病死率的主要因素。方法回顾性分析53例肺结核并发MODS患者资料,对筛选出的与30 d病死率相关的各项因素进行单因素分析及Logistic多元回归统计分析。结果单因素分析结果表明APACHEⅡ评分、肺结核病灶范围、血清白蛋白含量、肺结核并发症为肺结核并发MODS的30 d病死率的危险因素。肺结核病灶范围、低血清白蛋白、衰竭器官数目及肝衰可以作为肺结核并发MODS的独立预后因素。结论肺结核病灶累及范围、低血清白蛋白、衰竭器官数目及肝功能衰竭在肺结核并发MODS的预后中起着重要的作用。

Analysis on 53 patients with pulmonary tuberculosis complicated by MODS

Objective To evaluate the risk factors for motality of patients with pulmonary tuberculosis complicated by multiple organ dysfunction syndrome（MODS）. Methods The clinical data of 53 cases with pulmonary tuberculosis complicated by MODS were retrospectively analyzed. Univariate and multivariate analysis were used to examine the screened risk factors associated with pulmonary tuberculosis complicated by MODS. Results Univariate analysis showed that APACHE Ⅱ scores, extent of lung lesion, level of serum albumin and complications of pulmonary tuberculosis were risk factors of mortality of pulmonary tuberculosis complicated by MODS within thirty days. In a multivariate model, extent of pulmonary tuberculosis lesion, hypoproteinemia of serum albumin, the number of organ failure and hepatic failure were independent risk factors. Conclusion Extent of pulmonary tuberculosis lesion, hypoproteinemia of serum albumin, the number of organ failure and hepatic failure are important predictors of prognosis of pulmonary tuberculosis complicated by MODS.