摘要
目的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并呼吸衰竭是老年人常见病和多发病,严重影响老年人生活质量及生命健康。本研究分析老年COPD合并呼吸衰竭的相关危险因素,为临床预防及治疗提供依据。方法选择2016-03-15-2018-04-30广饶县大码头中心卫生院接收的84例COPD合并呼吸衰竭老年患者作为病例组,同时选取84例单纯COPD老年患者作为对照组。分析两组患者一般资料、肺功能指标、动脉血气指标以及降钙素原水平差异,采用多因素Logistic回归分析,明确COPD合并呼吸衰竭的影响因素。结果两组患者年龄(t=1.793,P=0.075)、体质量指数(t=0.240,P=0.811)和吸烟(χ2=2.885,P=0.089)比较,差异无统计学意义;病例组病程≥10年61例(72.62%),高于对照组的48例(57.14)%,差异有统计学意义,χ2=4.415,P=0.036。病例组动脉血氧分压(arterial oxygen partial pressure,PaO2)水平为(53.77±4.98)mm Hg,低于对照组的(64.10±4.58)mm Hg,t=13.981,P<0.001;病例组第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)水平为(2.16±0.12)L,低于对照组的(2.67±0.18)L,t=21.073,P<0.001;病例组二氧化碳分压(partial pressure of carbon dioxide,PaCO2)水平为(55.48±5.37)mm Hg,高于对照组的(46.94±3.04)mm Hg,t=12.671,P<0.001;病例组降钙素原(procalcitionin,PCT)水平为(0.76±0.13)ng/mL,高于对照组的(0.57±0.09)ng/mL,t=11.208,P<0.001;病例组第1秒钟用力呼气容积占预计值百分比(forced expiratory volume%of predicted value in the first second,FEV1/FVC)为(58.24±2.62)%,与对照组的(58.56±2.11)%差异无统计学意义,t=0.616,P=0.539;病例组pH值为7.36±0.14,与对照组的7.35±0.12比较差异无统计学意义,t=0.351,P=0.726。Logistic多元回归分析结果显示,病程长(OR=1.989,95%CI为1.043~3.793,P=0.037)、PaCO2水平高(OR=0.643,95%CI为0.561~0.737,P<0.001)和PCT水平高(OR=0.980,95%CI为0.974~0.986,P<0.001)是影响老年COPD患者合并呼吸衰竭的独立危
OBJECTIVE Chronic obstructive pulmonary disease(COPD)with respiratory failure is a common and frequently occurring disease in the elderly,which seriously affects the quality of life and health of the elderly.This study is to analyze the risk factors of COPD with respiratory failure in the elderly,providing basis for clinical prevention and treatment.METHODS From March 15,2016 to April 30,2018,a total of 84 elderly patients with COPD and respiratory failure received by Guangrao County grand wharf center health center were selected as the case group,and 84 elderly patients with COPD alone were selected as the control group.The clinical data,pulmonary function index,arterial blood gas index and procalcitonin level of the two groups were analyzed.The influencing factors of COPD combined with respiratory failure were determined by multi factor Logistic regression analysis.RESULTS There was no significant difference between the two groups in age(t=1.793,P=0.075),body mass index(t=0.240,P=0.811)and smoking(χ2=2.885,P=0.089);the course of disease in the case group was more than 10 years 61 cases(72.62%),higher than that in the control group48 cases(57.14%),the difference was statistically significant,χ2=4.415,P=0.036.The arterial oxygen partial pressure(PaO2)level of the case group was(53.77±4.98)mm Hg,lower than that of the control group(64.10±4.58)mm Hg,t=13.981,P<0.001);the forced expiratory volume in the first second(FEV1)level of the case group was(2.16±0.12)L,lower than that of the control group(2.67±0.18)L,t=21.073,P<0.001;the partial pressure of carbon dioxide(PaCO2)level of the case group was(55.48±5.37)mm Hg,higher than that of the control group(46.94±3.04)mm Hg The procalcitionin(PCT)level in the case group was(0.76±0.13)ng/ml,higher than that in the control group(0.57±0.09)ng/ml,t=11.208,P<0.001;Forced expiratory volume%of predicted value in the first second(FEV1/FVC)of the case group was(58.24±2.62)%and there was no significant difference between the case group and the control group(58.56±2.11)%,
作者
贾素花
王国丽
JIA Su-hua;WANG Guo-li(Department of Internal Medicine,Guangrao County Damatou Central Health Center,Guangraog257337,P.R.China)
出处
《社区医学杂志》
2020年第4期260-263,共4页
Journal Of Community Medicine
关键词
慢性阻塞性肺疾病
呼吸衰竭
吸烟史
降钙素原
老年人
chronic obstructive pulmonary disease
respiratory failure
smoking history
procalcitionin
elderly
