摘要
目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者再住院临床特征及影响因素。方法选取北京市第六医院2017年1月至2019年12月收治的AECOPD患者129例作为研究对象,根据患者3年内住院次数分为无再住院组(63例)和再住院组(66例)。比较两组患者基本特征和BODEx指数评分:包括体重指数(BMI)、肺功能指标(第1秒用力呼气容积占预计值百分比FEV1%pred)、呼吸困难量表(MRC)评分、急性加重频率、Charlson合并症指数(CCI)及外周血嗜酸性粒细胞绝对值计数(AEC)、中性粒细胞/淋巴细胞(NLR)、D二聚体(D-dimer)、B型脑钠肽(BNP)、白蛋白(ALB)和动脉血氧分压(PaO2)的差异。采用多因素Logistic回归分析,筛选出BODEx指数评分和CCI2个预测AECOPD患者发生再住院的影响因素。结果无再住院组BODEx指数评分、CCI、D-dimer、BNP低于再住院组,ALB高于再住院组(P<0.05),两组性别、年龄、AEC、NLR、PaO2差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,BODEx指数评分(OR=3.720,95%CI:2.127~6.505)及CCI(2.381,95%CI:1.422~3.986)是AECOPD患者发生再住院的危险因素。结论BODEx指数评分和CCI可预测AECOPD患者再住院风险,通过干预降低BODEx指数及CCI,可减少患者再住院风险,对再住院的早期干预有一定的临床价值。
Objective To investigate the clinical characteristics and influencing factors of readmission in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 129 patients with AECOPD admitted to Beijing No.6 Hospital(from January 2017 to December 2019)were selected and divided into no readmission group(n=63)and readmission group(n=66)according to the times of hospitalization within three years.The basic characteristics and BODEx index scores of the two groups were analyzed,including the differences in body mass index(BMI),pulmonary function index(forced expiratory volume in the first second as a percentage of the predicted value,FEV1%pred)(O),medical research council(MRC)dyspnea scale score(D),exercise tolerance(Ex),Charlson comorbidity index(CCI)and absolute eosinophil count(AEC),neutrophil-to-lymphocyte ratio(NLR),D dimer,brain natriuretic peptide(BNP),albumin(ALB)and arterial partial pressure of oxygen(PaO2).Then multivariate Logistic regression analysis was applied to select the influencing factors in BODEx index and CCI index for the prediction of readmission in AECOPD patients.Results Compared with the readmission group,the no readmission group had lower BODEX index score,CCI,D-dimer and BNP,and higher ALB(P<0.05).There was no significant difference in gender,age,AEC,NLR and PaO2 between the two groups(P>0.05).Multivariate Logistic regression analysis showed that BODEx index score(OR=3.720,95%CI:2.127-6.505)and CCI index(2.381,95%CI:1.422-3.986)were the risk factors for readmission in AECOPD patients.Conclusion BODEx index score and CCI index can predict the risk of readmission in AECOPD patients.The reducing of BODEx index and CCI index through intervention can reduce the risk of readmission in AECOPD patients,which has certain clinical value for early intervention of readmission.
作者
张童
魏丽娟
李冠颖
王连庆
Zhang Tong;Wei Lijuan;Li Guanying;Wang Lianqing(Department of Respiratory Medicine,Beijing No.6 Hospital,Beijing 100007,China;School of Humanities,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《成都医学院学报》
CAS
2023年第2期168-171,共4页
Journal of Chengdu Medical College
基金
大气污染成因与治理攻关项目(No:DQGG0402)。
