影响ARDS患者预后的危险因素分析

目的探讨并分析影响急性呼吸窘迫症（ARDS）患者预后的危险因素。方法收集86例ARDS患者的临床资料,用Logistic逐步回归法分析患者年龄、使用呼吸机、血糖、继发肺部感染、发病早晚及基础疾病与患者预后的关系,分析ARDS患者预后的危险因素。结果 86例ARDS患者死亡40例,存活46例,死亡率为46.51%（40/86）。其中感染组与非感染组,肺部感染组与非肺部感染组,合并基础疾病组与无基础疾病组、合并MODS组与无MODS组比较,感染组、肺部感染组、合并基础疾病组、合并MODS组死亡率高,差异有统计学意义（P〈0.05）。对患者年龄、基础疾病、感染原因导致的ARDS、机械通气、血糖、合并MODS、早发与晚发ARDS、确诊时APACHE评分、确诊时ALB指标、确诊时BUN指标进行单因素方差分析后,再对分析结果中具有统计学差异的变量进行Logistic多因素回归分析,结果显示,年龄、基础疾病、感染原因导致的ARDS、合并MODS、确诊时APACHEⅡ评分等可能是ARDS患者预后的危险因素。结论年龄、基础疾病、感染原因导致的ARDS、合并MODS、确诊时APACHEⅡ评分与ARDS患者预后密切相关。

Analysis of risk factors affecting prognosis of patients with ARDS

Objective To explore and analyze the risk factors affecting the prognosis of patients with acute respiratory distress syndrome(ARDS).Methods The clinical data of 86 patients with ARDS was collected.The Logistic stepwise regression analysis was used to analyze the relationship between the patient age,use of ventilator,blood glucose,secondary pulmonary infection and sooner or later onset of disease and the prognosis of the patients,and analyze the risk factors affecting the prognosis of patients with ARDS.Results Of the 86 patients with ARDS,40 patients died and 46 patients survived,with the mortality rate of 46.51%(40/86).The infection group,pulmonary infection group,combined underlying disease group and combined MODS group had higher mortality rate between the infection group and the non-infection group,the pulmonary infection group and the non-pulmonary infection group,the combined underlying disease group and the non-underlying disease group,and the combined MODS group and the non-MODS group,with statistical differences(P < 0.05).After the one-way ANOVA analysis of the patient age,underlying disease,infection-induced ARDS,mechanical ventilation,blood glucose,combined MODS,sooner and later onset of ARDS,APACHE score at confirmed diagnosis,ALB indicator at confirmed diagnosis and BUN indicator at confirmed diagnosis,the variables with statistical difference were analyzed with the Logistic multifactor regression.The results showed that age,underlying disease,infection-induced ARDS,combined MODS,APACHEⅡ score at confirmed diagnosis,etc.may be the risk factors affecting the prognosis of the patients with ARDS.Conclusion Age,underlying disease,infection-induced ARDS,combined MODS and APACHEⅡ score at confirmed diagnosis are closed correlated with the prognosis of the patients with ARDS.