急诊社区获得性肺炎患者中类肺炎性胸腔积液的危险因素分析

发布时间：2019-05-20 19:23

【摘要】：目的探讨急诊社区获得性肺炎(CAP)患者中类肺炎性胸腔积液(PPE)的常见危险因素。方法回顾性分析2014年1月至2016年11月于中国医科大学附属第一医院急诊科就诊的276例CAP患者的临床资料,根据是否存在PPE将276例患者分为PPE组和无PPE组(NPPE组),收集2组患者的临床资料,包括年龄、性别、生命体征、初诊的实验室检查指标、住院时间、28 d患者死亡率,计算2组患者的CURB-65评分,对各项因素进行单因素分析,单因素分析有显著意义的变量行二项分类logistic回归分析。结果 276例CAP患者中PPE组46例,NPPE组230例。患者是否存在PPE与年龄、性别、白细胞计数、血小板计数、丙氨酸氨基转移酶无关(P0.05),与低钠血症、低蛋白血症、降钙素原、CURB-65评分相关(P0.05)。二项分类logistic回归分析显示,低钠血症、低蛋白血症、降钙素原是PPE发生的独立危险因素。PPE组患者入住急诊ICU的比例更高(分别为22.1%和7.5%,P0.05),住院时间更长(中位时间分别为16和5 d,P0.05),但2组患者28 d死亡率的差异无统计学意义(P0.05)。结论低钠血症、低蛋白血症、降钙素原与PPE发生存在正相关,临床上应给予重视,积极调整治疗方案,改善患者预后。
[Abstract]:Objective to investigate the common risk factors of pulmonary inflammatory pleural effusions (PPE) in emergency community-acquired pneumonia (CAP) patients. Methods the clinical data of 276 patients with CAP treated in the Emergency Department of the first affiliated Hospital of China Medical University from January 2014 to November 2016 were analyzed retrospectively. according to the presence of PPE, 276 patients were divided into PPE group and non-PPE group (NPPE group). The clinical data of the two groups were collected, including age, sex, vital signs, newly diagnosed laboratory examination index, hospitalization time, 28 d mortality rate, the CURB-65 score of the two groups was calculated, and the factors were analyzed by univariate analysis. Univariate analysis has significant variable line binomial classification logistic regression analysis. Results there were 46 cases in PPE group and 230 cases in NPPE group. The presence of PPE was not related to age, sex, white blood cell count, platelet count and alanine aminotransferase (P 0.05), but correlated with hyponatremia, hypoalbuminemia, calmodulin and CURB-65 score (P 0.05). Two classification logistic regression analysis showed that hyponatremia, hypoalbuminemia and calcitonin were independent risk factors for the occurrence of PPE. The proportion of patients admitted to emergency ICU in PPE group was higher (22.1% and 7.5%, respectively, P 0.05). The hospital stay was longer (median time was 16 and 5 days, P 0.05), but there was no significant difference in 28 d mortality between the two groups (P 0.05). Conclusion there is a positive correlation between hyponatremia, hypoalbuminemia and calcitonin and the occurrence of PPE. Attention should be paid to it in clinic, and the treatment scheme should be adjusted actively to improve the prognosis of the patients.
【作者单位】：中国医科大学附属第一医院急诊科;
【分类号】：R561.3;R563.1

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