摘要
目的 探讨影响慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)相关肺动脉高压(pulmonary hypertension,PH)患者发生肺部感染的危险因素,为其临床预防及治疗提供参考.方法 回顾性分析广州医科大学附属第二医院2012年1月至2021年12月收治167例的COPD相关PH患者的临床资料,按照是否并发肺部感染分为感染组(85例)和未感染组(82例),比较两组的临床特征和实验室检查指标,分析其危险因素.结果 167例COPD相关PH患者中85例并发肺部感染,占比50.9%.单因素分析结果显示,感染组吸烟史、美国纽约心脏病学会(NYHA)分级(Ⅱ、Ⅲ、Ⅳ级)、重症、住院时间、住院费用、肺动脉收缩压(PASP)、脑钠肽(BNP)、C-反应蛋白(CRP)、白细胞计数均显著高于未感染组(P<0.05).感染组体重指数(BMI)、人血白蛋白、总胆固醇、三酰甘油均显著低于未感染组(P<0.05).多因素Logistic回归分析发现:吸烟史、NYHA(Ⅱ、Ⅲ、Ⅳ)级、重症、BNP升高是COPD相关PH患者肺部感染的独立危险因素(均P<0.05).结论 在临床治疗过程中要重视对COPD相关PH患者并发肺部感染的高危因素进行积极治疗及控制,以便有效降低患者肺部感染发生概率.
Abstract
Objective To investigate the risk factors for pulmonary infection in patients with chronic obstructive pulmonary disease(COPD)related pulmonary hypertension(PH),and to provide reference for clinical prevention and treatment.Methods The clinical data of 167 patients with COPD related PH admitted to the Second Affiliated Hospital of Guangzhou Medical University from January 2012 to December 2021 were retrospectively analyzed,and they were divided into infected group(85 cases)and uninfected group(82 cases)based on whether there is concurrent pulmonary infection.The clinical characteristics,laboratory test indexes,and risk factors were compared between the two groups.Results Among 167 COPD related PH patients,85 cases were complicated with pulmonary infection,accounting for 50.9%.Univariate analysis showed that smoking history,the New York Heart Association(NYHA)classification(Ⅱ,Ⅲ,Ⅳ),severe disease,hospital length of stay,hospitalization cost,pulmonary artery systolic blood pressure(PASP),brain natriuretic peptide(BNP),C-reactive protein(CRP),and white blood cell count in the infected group were significantly higher than the uninfected group(P<0.05).The body mass index(BMI),serum albumin,total cholesterol and triglyceride of infected group were significantly lower than those of uninfected group(P<0.05).Multivariate Logistic regression analysis showed that smoking history,NYHA grade(Ⅱ,Ⅲ,Ⅳ),severe disease,and elevated BNP were independent risk factors for pulmonary infection in patients with COPD related PH(P<0.05).Conclusion In the clinical treatment process,it is important to actively treat and control the high-risk factors for pulmonary infection in patients with COPD related PH,in order to effectively reduce the probability of pulmonary infection in patients.
维普
万方数据