老年重症肺炎患者预后的影响因素分析
发布时间：2018-03-06 21:07
本文选题：重症肺炎 切入点：老年 出处：《山东医药》2017年12期 论文类型：期刊论文
【摘要】：目的探讨老年重症肺炎患者预后的影响因素。方法选择老年重症肺炎患者428例,根据入院14天病情转归情况分为迁延恶化组193例、好转组235例,对两组一般临床因素(如性别、年龄、基础心率、平均动脉压、原发病情况)、相关生化指标[治疗前和治疗1、3天血清胆碱酯酶(S-ChE)、过氧化脂质(LPO)、肝功能(ALT、AST)、肾功能(Scr、BUN)、血常规(WBC、PLT)、凝血功能(APTT)]、病情诊治情况[急性生理与慢性健康评分Ⅱ(APACHEⅡ)、多脏器功能障碍综合征(MODS)评分、氧合指数(PaO_2/FiO_2)、病原微生物及机械通气治疗情况]进行对比分析。将两组上述因素比较有统计学差异的指标进行二元Logistic多因素回归分析,筛选老年重症肺炎患者预后的危险因素。结果两组一般临床因素各指标比较P均0.05。生化指标相关因素中,两组血清S-Ch E、LPO及有S-Ch E降低趋势者、有LPO增高趋势者例数比较P均0.05,其余指标比较P均0.05。重症肺炎相关因素中,两组APACHEⅡ评分、MODS评分、PaO_2/FiO_2比较P均0.05,其余指标比较P均0.05。二元Logistic多因素回归分析显示,血清S-Ch E水平降低、LPO水平升高及APACHEⅡ评分、MODS评分升高者预后相对较差。结论APACHEⅡ评分、MODS评分及血清S-ChE、LPO水平是老年重症肺炎患者预后的影响因素。
[Abstract]:Objective to investigate the prognostic factors of elderly patients with severe pneumonia. Methods 428 elderly patients with severe pneumonia were divided into two groups according to the prognosis of 14 days after admission: 193 cases in the prolonged exacerbation group and 235 cases in the improved group. The general clinical factors (such as sex) in the two groups were analyzed. Age, basic heart rate, mean arterial pressure, Serum cholinesterase S-Chem, Lipid peroxide LPOP, liver function alt ASTN, Renal function Scr-BUNT, Blood routine examination WBCClP, Coagulation function APTTT], diagnosis and treatment of the disease [Acute Physiology and chronic Health scale 鈪, related biochemical indexes [serum cholinesterase S-Chem, lipid peroxidation, liver function, liver function, Scr-BUNT, blood routine test, coagulation function, APTTT], serum cholinesterase S-Chem, lipid peroxide, liver function, liver function, liver function and kidney function. Apache 鈪，
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