摘要
目的探讨经急诊住院的初治肺结核患者的死亡原因,旨在减少初治肺结核患者死亡率。方法回顾性分析2015年1月-2017年12月经我院急诊收治的初治肺结核患者1634例,死亡67例,作为研究组,随机选取未死亡患者65例作为对照组,比较两组的各项临床观察指标,行单因素分析;对有显著性差异的指标进行多因素分析,以发现初治肺结核患者死亡原因。单因素分析采用χ2检验,多因素分析采用Logistic回归分析。结果 1634例急诊收治的初治肺结核患者,住院28天死亡67例(4. 10%),两组比较进行单因素分析发现:高龄、痰菌阳性、血白细胞升高、合并下呼吸道感染、贫血、低蛋白血症、合并糖尿病、呼吸功能衰竭、冠心病、脑血管病以及延迟就医(发病到医院就诊时间大于4周)是初治肺结核患者死亡的原因。对这些因素进一步行多因素分析显示,低蛋白血症是初治肺结核患者死亡的危险因素。结论本研究发现低蛋白血症是初治肺结核患者死亡的危险因素。
Objective To analyze the risk factors of death in the initial treatment of pulmonary- tuberculosis patients in the emergency deparlment, so as to reduce the mortality of initial treatment of pulmonary- tuberculosis pa- tients. Methods A total of 1634 cases of initial treated pulmonary tuberculosis patients in Emergency department of Beijing Chest Hospital from January-2015 to December 2017 were retrospectively investigated. Among them, 67 patients died were selected as the study group, and 65 survival patients were selected as the control group. The clinical data of the two groups were collected and analyzed by univariate analysis and multivariate analysis of significant differenee in order to find out the cause of death index, initial treated pulmonary tuberculosis patients. Chi square test was used for univariate analysis, and multivariate analysis was analyzed by Logistic regression analysis. Results Among 1634 cases of initial treatment pulmonary tuberculosis patients admitted in emergency department, 67 cases （4. 10% ） died during 28 days of hospitalization. The results of univariate analysis showed there were significant differences in age, sputum positive, elevated blood leukoeytes, lower respiratory tract infection, anemia, hypoproteinemia, diabetes mellitus, respiratory failure, coronary heart disease, eerebrovaseular disease, and delayed medical attention （ the time for hospital visits is more than 4 weeks）. Further multivariate analysis of these factors showed that hypoproteinemia and delayed medical attention were the risk factors. Conclusion The results indicate that hypoproteinemia is an important risk factor leading to death in the initial treatment of pulmonary tuberculosis patients.
作者
李加涛
李文胜
陈燕琴
李有才
张静
LI Jia-tao;LI Wen-sheng;CHEN Yan-qin;LI YOU-Cai;ZHANG Jing(Emergency Department,Beijing Chest Hospital of Capital Medical University,Beijing 101149,China)
出处
《临床肺科杂志》
2018年第11期1971-1973,1977,共4页
Journal of Clinical Pulmonary Medicine
关键词
初治肺结核
死亡
低蛋白血症
危险因素
initial-treated pulmonary tuberculosis
death
hypoproteinemia
risk factors
