首页|代谢综合征及其组分对重症肺炎患者病情及预后的影响

代谢综合征及其组分对重症肺炎患者病情及预后的影响

Influence of the metabolic syndrome and its components on the condition and prognosis of patients with severe pneumonia

扫码查看
目的 探讨代谢综合征(metabolic syndrome,MS)及其组分对重症肺炎患者病情及预后的影响.方法 纳入2020年1月~2023年7月在广东省中医院重症监护病房收治的306例重症肺炎患者作为研究对象.根据是否合并MS将患者分为MS组和非MS组,并根据28天预后情况分为生存组和死亡组,对MS组和非MS组的一般资料、实验室指标、病情及预后指标等进行比较;采用多因素Logistic回归分析重症肺炎患者预后的独立危险因素.结果 MS组的体重指数(body mass index,BMI)、空腹血糖(fasting blood glucose,FBG)、甘油三酯(triglyceride,TG)、血乳酸(lactate,LAC)、血白细胞计数(white blood cell count,WBC)、血尿素(urea phosphate,Urea)、血肌酐(creatinine,SCr)水平,急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)、休克、多器官功能衰竭综合征(multiple organ dysfunction syndrome,MODS)、气管插管发生率,死亡率,ICU治疗费用、总治疗费均显著高于非MS组(P<0.05);MS组高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、氧合指数(oxygenation index,O1)水平显著低于非MS组(P<0.05).多因素Logistic回归分析显示,合并MS的重症肺炎死亡风险比没有合并MS的高1.276倍(95%CI:1.013,5.114,P=0.047);亚组分析结果也显示,合并MS的非病毒性重症肺炎死亡风险比没有合并MS的高2.147倍(95%CI:1.175,8.428,P=0.023).结论 合并MS的重症肺炎患者病情可能更重,预后可能更差.
ObjectiveTo explore the effects of Metabolic Syndrome(MS)and its components on the condition and prognosis of patients with Severe Pneumonia.Methods306 patients with severe pneumonia admitted to the intensive care unit of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2020 to July 2023 were included as study subjects.The patients were divided into MS and non-MS groups according to whether they were combined with MS,and into survival and death groups according to 28-day prognosis,and the general data,laboratory indexes,condition and prognostic indexes of the two groups were compared;multifactorial logistic regression was used to analyze the independent risk factors for the prognosis of patients with severe pneumonia.Results The levels of test indicators such as body mass index(BMI),fasting blood glucose(FBG),triglyceride(TG),blood lactate,white blood cell count(WBC),urea phosphate(Urea),creatinine(SCr),as well as the incidence of acute respiratory distress syndrome(ARDS),shock,multiple organ dysfunction syndrome(MODS),rate of endotracheal intubation and mortality,ICU treatment cost,and total treatment cost of the MS group were significantly higher than those of the non-MS group;the levels of high-density lipoprotein cholesterol(HDL-C)and oxygenation index(OI)of the MS group were significantly lower than those of the non-MS group(P<0.05).Multifactorial logistic regression analysis showed that the risk of death from severe pneumonia was 1.276 times higher in combined MS than in no combined MS(95%CI:1.013,5.114,P=0.047).Subgroup analyses also showed that the risk of death from non-viral severe pneumonia was 2.147 times higher in those with MS than those without(95%CI:1.175,8.428,P=0.023).Conclusion Severe pneumonia with MS may be more severe and may have a worse prognosis.

Metabolic syndromeSevere pneumoniaPrognosis

张静、王徽徽、邓华英、赖芳、周耿标、韩云

展开 >

广州中医药大学第二临床医学院(广东广州 510405)

广州中医药大学第一临床医学院(广东广州 510010)

广州中医药大学第二附属医院,广东省中医院(广东广州 510120)

广东省中医院晁恩祥学术经验传承工作室(广东广州 510120)

广东省中医急症研究重点实验室(广东广州 510120)

展开 >

代谢综合征 重症肺炎 预后

国家自然科学基金

82104610

2024

中国呼吸与危重监护杂志
四川大学华西医学中心,四川大学华西医院

中国呼吸与危重监护杂志

CSTPCD
影响因子:1.306
ISSN:1671-6205
年,卷(期):2024.23(4)
  • 21