摘要
目的探讨影响肺结核合并呼吸衰竭患者预后的相关因素。方法收集2017年4月至2019年6月该院收治的肺结核并发呼吸衰竭患者共98例,按照患者转归情况分为死亡组和生存组,采用logistic回归模型分析与肺结核合并呼吸衰竭患者预后密切相关的影响因素。结果98例患者按照转归情况分为生存组73例,死亡组25例,病死率25.51%;单因素分析结果显示,吸烟史、有多器官功能障碍综合征(MODS)、Ⅱ类呼吸衰竭、急性生理及慢性健康评分表(APACHEⅡ)评分≥25分是影响肺结核合并呼吸衰竭患者预后的相关因素(P<0.05);logistic多因素分析模型显示,APACHEⅡ评分≥25分、Ⅱ型呼吸衰竭、MODS为肺结核合并呼吸衰竭患者预后独立危险因素(P<0.05),其中APACHEⅡ评分≥25分且未入住ICU治疗患者的病死率为入ICU治疗的3.500倍(95%CI:1.826~4.966),差异有统计学意义(P<0.05)。结论APACHEⅡ评分≥25分、Ⅱ型呼吸衰竭、发生MODS是肺结核合并呼吸衰竭患者死亡的独立危险因素,且对于APACHEⅡ评分≥25分的患者早期转入重症医学科进行积极干预,可改善患者预后。
Objective To explore the related factors affecting the prognosis of patients with pulmonary tuberculosis complicated with respiratory failure.Methods A total of 98 patients with pulmonary tuberculosis complicated with respiratory failure admitted to our hospital from April 2017 to June 2019 were collected.According to the outcome of the patients,the patients were divided into the death group and the survival group.Logistic regression model was used to analyze the influencing factors closely related to the prognosis of patients with pulmonary tuberculosis complicated with respiratory failure.Results According to the patient′s outcome,there were 73 patients in the survival group and 25 patients in the death group.The mortality rate was 25.51%.The univariate analysis showed that the factors affecting the prognosis of patients with pulmonary tuberculosis and respiratory failure included age,BMI,smoking history,mechanical ventilation,respiratory failure type,APACHEⅡscore,ICU,MODS(P<0.05).Logistic multivariate analysis showed that APACHEⅡscore≥25,typeⅡrespiratory failure and MODS were independent risk factors for pulmonary tuberculosis complicated with respiratory failure(P<0.05).Among them,the APACHEⅡscore≥25 and the incidence of death in patients without ICU treatment was 3.500 times of ICU treatment(95%CI:1.826-4.966),and the difference was statistically significant(P<0.05).Conclusion APACHEⅡscore≥25,typeⅡrespiratory failure,and MODS are independent risk factors for death in patients with pulmonary tuberculosis and respiratory failure,and early intervention in patients with APACHEⅡscore≥25 can improve the prognosis of patients.
作者
何仪
贾仕群
HE Yi;JIA Shiqun(Xi′an Chest Hospital,Xi′an,Shaanxi 710000,China)
出处
《检验医学与临床》
CAS
2020年第12期1688-1690,共3页
Laboratory Medicine and Clinic
关键词
肺结核
呼吸衰竭
危险因素
预后
tuberculosis
respiratory failure
risk factors
prognosis
