肺心病死亡原因及危险因素的多因素logistic回归分析

目的探讨肺心病患者的死亡原因及危险因素。方法对2003年1月-2007年3月间我院收治的26例肺心病死亡病例进行研究，按照1：1配对方法，随机选择同科室、同时期住院的肺心病患者26例作为对照组。选择12个可能对肺心病死亡率产生影响的特征性因素，通过计算机logistic回归模型进行多因素分析。结果死亡原因：多脏器功能衰竭17例（65．4％），呼吸衰竭5例（19．2％）（其中肺性脑病4例），痰阻窒息2例（7．7％），猝死2例（7．7％）。影响肺心病死亡率的主要危险因素是：伴随症数（OR17．093）、电解质紊乱（OR16．577）、合并症数（OR15．881）、住院天数（OR15．587）和合理使用抗菌药（OR9．651）等5个指标（P〈0．05）。结论降低肺心病死亡率，应重视早期抗菌药的合理应用，积极处理各种合并症及伴随症。

The reason of death and risk factors in patients with pulmonary heart disease by logistic regression model

Objective To explore the risk factors and causes affecting the mortality in patients with pulmonary heart disease. Methods 26 died cases with pulmonary heart disease hospitalized from Jan, 2003 to Mar, 2007 as a group, and 26 survival cases hospitalized at the same time, in same department , as another group, twelve factors that may influence the mortality were selected. A multi-variate analysis of these individual variables was performed by the computer＇s logistic regression model. Results The causes of death included multiple organ failure 17 case （65.4%）, respiratory failure 5 case （19. 2% ） （including 4 case with pulmonary encephalopathy）, stagnation of phlegm 2 case（7.7% ） and sudden death 2 case（7.7% ）. The results showed that the major risk factors that affected mortality in cases with pulmonary heart disease were numbers of accompaniment disease, electrolyte disturbances, the numbers of complication, hospital day and rational use antibacterial agent （ P 〈 0.05 ）. Conclusion To minimize mortality of pulmonary heart disease, some means must be noticed, including the Tational use antibacterial agent in time and disposing complications well arranged.