摘要
目的观察老年重症肺炎患者血小板参数、氧合指数(OI)与其预后间的联系。方法回顾性选取2016年4月至2019年8月重庆市中医院救治后28 d内死亡的35例老年重症肺炎患者(死亡组),及同时期未死亡的70例重症肺炎患者(存活组),记录2组患者的基线资料、急性生理功能与慢性健康评分(APACHEⅡ)、外周血白细胞(WBC)、中性粒细胞(N)、pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、白蛋白(ALB)等指标情况,同时观察患者血小板参数、OI水平并对比患者合并疾病情况;采用多因素分析探究血小板参数、OI等指标与患者预后间的联系。结果死亡组和存活组患者基础资料、合并症情况、肾功能不全以及外周血WBC水平比较,差异无统计学意义(P>0.05);死亡组患者多器官功能障碍综合征(MODS)发生率、合并心功能不全发生率、APACHEⅡ评分、N、PaCO_(2)测定值高于存活组,住院时间、pH值、PaO_(2)、ALB测定值低于存活组,差异均有统计学意义(P<0.05)。死亡组PLT、OI测定值较存活组更低,而MPV、PDW高于存活组,差异均有统计学意义(P<0.05)。多因素分析显示:APACHEⅡ评分增高、发生MODS、pH值降低、发生心功能不全、PLT值降低、OI值降低是老年重症肺炎患者治疗不良结局的独立危险因素(P<0.05)。结论老年重症肺炎患者治疗不良结局的影响因素很多,PLT值降低、OI值降低可能会加大患者不良预后的风险。
Objective To observe the relationship between platelet parameters,oxygenation index(OI)and prognosis in elderly patients with severe pneumonia.Methods Collected 35 elderly patients with severe pneumonia(death group)who died within 28 days after treatment at Chongqing Traditional Chinese Medicine Hospital from April 2016 to August 2019 through retrospective research,and 70 patients with severe pneumonia who did not die during the same period(survival group).Record baseline data,acute physiological function and chronic health score(APACHEⅡ),peripheral blood white blood cells(WBC),neutrophils(N),pH,arterial partial pressure of oxygen(PaO_(2)),and arterial carbon dioxide of the two groups of patients Partial pressure(PaCO_(2)),albumin(ALB)and other indicators,while observing the patient's platelet parameters,OI levels and comparing patients with disease conditions;using multi-factor analysis to explore the relationship between platelet parameters,OI and other indicators and patient prognosis.Results There was no statistically significant difference in basic data,comorbidities,renal insufficiency,and peripheral blood WBC levels between the death group and the survival group(P>0.05);The incidence of multiple organ dysfunction syndrome(MODS),the incidence of combined cardiac dysfunction,APACHEⅡscore,N and PaCO_(2)in the death group were higher than those in the survival group,while the length of hospital stay,pH,PaO_(2),and ALB were lower than those in the survival group,the differences were statistically significant(P<0.05).The measured values of PLT and OI in the death group were lower than those in the survival group(P<0.05),while MPV and PDW were higher than those in the survival group(P<0.05).Logistic multivariate analysis showed that increased APACHEⅡscore,occurrence of MODS,decreased pH value,occurrence of cardiac insufficiency,decreased PLT value,and decreased OI value were independent risk factors for adverse treatment outcomes in elderly patients with severe pneumonia(P<0.05).Conclusion In clinical pract
作者
陈秀琴
黄玉麟
汤俊
CHEN Xiu-qin;HUANG Yu-lin;TANG Jun(Department of Laboratory Medicine,Chongqing Hospital of Traditional Chinese Medicine/Infectious Diseases Diagnosis and Treatment Laboratory of Integrated Traditional Chinese and Western Medicine,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Laboratory Medicine,Wuxi County Hospital of Traditional Chinese Medicine,Chongqing 405800,China.)
出处
《临床和实验医学杂志》
2021年第11期1195-1198,共4页
Journal of Clinical and Experimental Medicine
基金
重庆市卫生计生委医学科研项目(编号:2017MSXM152)。
关键词
重症肺炎
血小板参数
氧合指数
预后结局
Severe pneumonia
Platelet parameters
Oxygenation index
Prognosis outcome
