肺气肿和肺功能对慢性阻塞性肺疾病患者肺炎病情发展的影响

摘要

目的 探讨肺气肿和肺功能对慢性阻塞性肺疾病(慢阻肺)患者肺炎病情发展的影响.方法选择2008年1月-2012年12月来我院接受治疗的慢阻肺患者140例.根据随访结果有无肺炎发生分为慢阻肺发生肺炎组(n=60)和慢阻肺未发生肺炎组(n=80).比较两组患者在一般资料、肺气肿及肺功能指标上的差异,应用单因素、多因素非条件Logistic回归分析进行影响慢阻肺患者发生肺炎的危险因素分析,并应用Kaplan-Meier生存分析比较不同慢阻肺阻塞程度对肺炎病情发展的影响.结果140例慢阻肺患者经随访,60例发生肺炎,80例未发生肺炎.两组患者在年龄、BMI、SGRQ评分、6min步行试验、吸入支气管扩张剂后FEV1占预计值百分比、LAA-950、平均肺密度比方面差异显著(P<0.05).单因素、多因素Logistic回归分析结果显示,吸入支气管扩张剂后FEV1占预计值百分比、LAA-950、6min步行试验是影响慢阻肺患者发生肺炎的危险性因素(P<0.05).其中,以LAA-950指标为主的肺气肿出现异常、以吸入支气管扩张剂后FEV1占预计值百分比和6min步行试验指标为主的肺功能出现异常的慢阻肺患者易发生肺炎.Kaplan-Meier生存分析显示:重度阻塞患者发生肺炎可能性更大(P<0.05).结论LAA-950、吸入支气管扩张剂后FEV1占预计值百分比、6min步行试验结果是影响慢阻肺患者肺炎病情发展的重要危险性因素.%Objective To investigate the effect of pulmonary emphysema and pulmonary function on the de-velopment of pneumonia in patients with chronic obstructive pulmonary disease (COPD). Methods 140 patients with COPD in our hospital from Jan 2008 to Dec 2012 were selected as study subjects. According to the Results of follow-up, they were divided into the COPD without pneumonia group (n=60) and the COPD with pneumonia group (n=80). The difference in general information, emphysema and pulmonary function index of the two groups were compared. Univariate and multivariate unconditional Logistic regression analysis were used to analyze the risk factors, and Kaplan-Meier survival analysis was used to compare the effect of different COPD obstruction on the development of pneumonia. Results 140 COPD patients were followed up, pneumonia occurred in 60 cases, and no pneumonia occurred in 80 cases. There were significant differences in age, BMI, SGRQ score, 6min walking test, inhaled bron-chodilator FEV1 accounted for the expected value of the percentage, LAA-950, and the average lung density ratio be-tween the two groups (P<0. 05). Single factor and multi factor Logistic regression analysis showed that after inhaling bronchodilators FEV1 percentage of predicted value, LAA-950 and 6min walking test were risk factors influencing the occurrence of pneumonia in patients with COPD (P<0. 05). Among them, the LAA-950 index of emphysema, after inhaling bronchodilators FEV1 percentage of predicted value and 6min walking test index were abnormal which could cause COPD patients with pneumonia. Kaplan-Meier survival analysis showed a greater likelihood of pneumonia in pa-tients with severe obstruction (P<0. 05). Conclusion LAA-950, the percentage of FEV1 after inhalation of bron-chodilator and the result of 6min walking test are important risk factors for the development of pneumonia in patients with COPD.