Objective: The objective of this study was to analyze influencing factors of survival rate of acute lung injury (ALI )and acute respiratory distress syndrome (ARDS ) patients. Methods: The clinical data of 39 ALI and 98 ARDS patients who were treated in our hospital from March 2013 to May 2017 were retrospectively analyzed after excluding patients who died within 24 h following hospitalized and had the acute left heart failure and cardiogenic pulmonary edema. Based on the prognosis and outcome, the surviving patients were classified into survival group and died patients were the death group. The baseline data that were statistically significant of the two groups were analyzed by Logistic regression analysis, and the risk factors influencing the survival rate of ALI and ARDS patients were determined. Results: 52 out of 137 patients died, with the survival rate of 62.04%, among which the survival rate of 39 ALI patients was 89.74% (35/39) and 51.02% (50/98) in the 98 ARDS patients. The survival rate of ARDS patients was lower than ALI patients, the difference was statistically significant (P<0.05). The score of APACHE Ⅱ(over 20 score), duration of mechanical ventilation (more than 7 days), oxygenation index (less than 200 mmHg), blood urea nitrogen (greater than 7.1 mmol/L), pulmonary endogenous disease and sepsis were the independent risk factors influencing survival rate of ALI and ARDS patients (P<0.05). Conclusion: Survival rate of ALI and ARDS patients is comparatively lower and influenced by various factors. Timely prognosis assessment and comprehensive treatment should be implemented, with the view to managing the disease progression and improving their survival rate.%目的:分析影响急性肺损伤(Acute lung injury,ALI)/急性呼吸窘迫综合征(Acute respiratory distress syndrome,ARDS)患者生存率的因素.方法:回顾2013年3月至2017年5月我科ALI/ARDS患者资料,剔除入院后24 h内病死者及合并急性左心衰竭、心源性肺水肿患者,39例AL、98例ARDS患者入组.按照患者入院30 d预后转归,将生存患者纳入生存组,死亡患者纳入病死组,将两组患者基线临床资料存在统计学差异的因素纳入Logistic多因素回归分析,总结影响ALI合并ARDS患者生存率的相关危险因素,探讨防治对策.结果:137例患者中,52例病死,生存率为62.04%,其中39例ALI患者生存率为89.74%(35/39),98例ARDS患者生存率为51.02%(50/98),ARDS患者生存率低于ALI患者,差异有统计学意义(P<0.05).APACHE Ⅱ评分≥20分、机械通气治疗时间≥7 d、氧合指数<200 mmHg、尿素氮≥7.1 mmol/L、肺内源性病因及发生脓毒血症均为影响ALI/ARDS患者生存率的独立危险因素(P<0.05).结论:ALI/ARDS患者生存率较低且受多种因素影响,及时评估患者预后质量并给予综合干预,有望控制病情进展、提高患者生存率.
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