慢性阻塞性肺病并发急性呼吸衰竭的危险因素分析

目的探讨慢性阻塞性肺疾病(COPD)并发急性呼吸衰竭的相关危险因素及预后因素,为临床防治策略的制定提供参考依据。方法选取我院呼吸内科收治的COPD患者148例,根据是否有并发急性呼吸衰竭分为急性呼衰组52例和非急性呼衰组96例。根据急性呼衰组患者的转归情况,将其分为好转组36例以及死亡组16例。分析慢性阻塞性肺疾病并发急性呼吸衰竭的危险因素,并研究急性呼吸衰竭预后的相关因素。结果每年发生慢性阻塞性肺病急性发作次数多、尿酸水平低、白蛋白水平低、消瘦、发生医院感染、未使用吸入用糖皮质激素、酸碱失衡是COPD致急性呼吸衰竭的危险因素;而酸碱值低、血二氧化碳分压升高、血清钠降低、血清氯低、医院感染、并发肺性脑病、并发心功能衰竭是COPD并发急性呼吸衰竭患者预后的危险因素。结论慢性阻塞性肺疾病并发急性呼吸衰竭与COPD发作的次数、机体营养状况、电解质酸碱失衡、医院感染的发生、吸入用糖皮质激素的使用等多个危险因素有关。

Analysis of risk factors of chronic obstructive pulmonary disease combined with acute respiratory failure

Objective To analyze the risk factors and prognostic factors of chronic obstructive pulmonary disease （COPD） combined with acute respiratory failure, in order to provide the reference for clinical prevention and treatment strategies. Methods 148 patients with chronic obstructive pulmonary disease in our hospital of respiratory department were selected, and were divided into acute respiratory failure group （52 cases） and non acute respiratory failure group （96 cases） according to associated with acute respiratory failure or not. The acute respiratory failure group was divided into improved group （36 cases） and death group （16 cases） according to the prognosis of acute respiratory failure. The risk factors of chronic obstructive pulmonary disease （COPD） combined with acute respiratory failure and prognostic factors of acute respiratory failure were analyzed. Results Occurs acute exacerbation of chronic obstructive pulmonary disease frequency every year, lower serum UA level, decreased albumin, weight loss, hospital infection, without receiving inhaled corticosteroids and acid-base imbalance were the risk factors of chronic obstructive pulmonary disease （COPD） combined with acute respiratory failure; lower pH value, the rose of pressure of carbon dioxide, decreased serum sodium and chloride, hospital infection, complicated with pulmonary encephalopathy and heart failure were the prognostic factors. Conclusions COPD frequency, nutritional status, acid-base imbalance hospital infection, without receiving inhaled corticosteroids are the risk factors of chronic obstructive pulmonary disease （COPD）combined with acute respiratory failure.