慢性阻塞性肺疾病合并支气管扩张症患者临床特征及预后相关因素分析

摘要

Objective To explore the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) complicated with bronchiectasis, and analyze the its prognostic factors. Methods A total of 330 COPD cases in our hospital were divided into group A (simple COPD) and group B (COPD and bronchiectasis) which were divided into survival group and death group according to different prognostic results. The influencing factors of prognosis in COPD patients with bronchiectasis were analyzed by regression analysis. Results There were significant differences in body mass index, history of tuberculosis, duration of symptoms and sputum color between group A and group B (P ＜ 0. 05). The percentage of forced vital capacity to predicted value (FVC％ predicted value), percentage of forced expiratory volume in the first second to predicted value (FEV1％ predicted value), ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC predicted value), partial pressure of blood oxygen [p (O2) ]and albumin level in group A were higher than those in group B (P ＜ 0. 05). The levels of partial pressure of blood carbon dioxide [p (CO2) ], hemoglobin (Hb) and erythrocyte sedimentation rate (ESR) in group A were lower than those in group B (P ＜ 0. 05). There were 33 patients died in group B, with a mortality rate of 22. 76％. Univariate analysis showed that age, duration of symptoms, p (CO2) and albumin were related factors for the prognosis of COPD patients with bronchiectasis, and binary logistic regression analysis showed that age, albumin and duration of symptoms were risk factors for death of COPD patients with bronchiectasis (P ＜ 0. 05 or P ＜ 0. 01). Conclusion The prognosis of COPD patients with bronchiectasis is closely related to age, albuminand duration of symptoms, and albumin level should be monitored.%目的 探讨慢性阻塞性肺疾病(COPD)合并支气管扩张症患者的临床特征及预后相关因素.方法 收集330例COPD患者分为A组(单纯COPD患者)和B组(COPD合并支气管扩张症患者).根据不同预后结果将COPD合并支气管扩张患者分为存活组与死亡组,通过回归分析筛查影响COPD合并支气管扩张症患者预后的相关因素.结果 A组与B组在体质量指数、肺结核病史、症状持续时间、痰色方面比较,差异有统计学意义(P ＜0.05);A组的用力肺活量占预计值百分比(FVC％预计值)、第1秒用力呼气容积占预计值百分比(FEV1％预计值)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、血氧分压[p(O2)]和白蛋白水平显著高于B组(P ＜0.05);A组的二氧化碳分压[p(CO2)]、血红蛋白(Hb)、红细胞沉降率(ESR)水平显著低于B组(P ＜0.05).B组中有33例患者死亡,病死率为22.76％.单因素分析结果显示,年龄、症状持续时间、p(CO2)、白蛋白是影响COPD合并支气管扩张患者预后的相关因素;二元Logistic回归分析结果显示,年龄、白蛋白水平、症状持续时间是影响COPD合并支气管扩张症患者生存状况的危险因素(P ＜0.05或P ＜0.01).结论COPD合并支气管扩张症患者的预后与年龄、白蛋白、症状持续时间密切相关,需注意监测患者白蛋白水平的变化.