老年肺结核患者并发呼吸衰竭的危险因素分析OA北大核心CSTPCD
Analysis of risk factors of respiratory failure in elderly patients with pulmonary tuberculosis
目的:分析老年肺结核患者并发呼吸衰竭的情况及危险因素.方法:采用回顾性研究方法,选取2021年1月至2023年6月江苏省溧阳市人民医院收治的210例老年肺结核患者作为研究对象.其中,100例并发呼吸衰竭,作为观察组;110例未并发呼吸衰竭,作为对照组.收集两组研究对象的临床资料,包括年龄、性别、病程、体质量指数、吸烟史、既往肺部疾病史、肺结核治疗分类、主要临床症状、实验室检查结果、影像学检查结果等,并进行比较;采用logistic回归模型,分析老年肺结核患者并发呼吸衰竭的危险因素.结果:观察组复治患者比例为47.0％(47/100),明显高于对照组的29.1％(32/110),差异有统计学意义(x2=7.159,P=0.007);白细胞计数水平和降钙素原水平分别为(11.50±2.63)× 109/L和(0.71±0.25)μg/L,均明显高于对照组[分别为(4.62± 2.41)×109/L和(0.29±0.17)μg/L],差异均有统计学意义(t值分别为19.782和14.347,P值均＜0.001).对照组血清白蛋白水平为(31.37±7.56)g/L,明显高于观察组的(24.61±6.72)g/L,差异有统计学意义(t=6.821,P＜0.001).多因素logistic回归分析显示,复治肺结核[OR(95％CI)=1.262(1.151～1.968)]、血清白细胞计数水平升高[OR(95％CI)=2.268(1.278～3.343)]、降钙素原水平升高[OR(95％CI)=1.751(1.408～3.513)]、血清白蛋白水平降低[OR(95％CI)=0.893(0.762～0.969)]均是老年肺结核患者合并呼吸衰竭的独立危险因素.结论:复治肺结核、白细胞计数和降钙素原水平升高、血清白蛋白水平降低均是老年肺结核并发呼吸衰竭的独立危险因素,临床医师在对老年肺结核患者进行诊疗时,应针对上述因素予以警惕,采取有效的治疗措施,以减少老年肺结核患者并发呼吸衰竭.
Objective:To analyze the situation and risk factors of respiratory failure in elderly patients with pulmonary tuberculosis.Methods:Using a retrospective research method,210 elderly pulmonary tuberculosis patients admitted to Liyang People's Hospital in Jiangsu Province from January 2021 to June 2023 were selected as the study subjects.Among them,100 cases with concurrent respiratory failure were selected as the observation group;110 cases without concurrent respiratory failure were selected as the control group.Clinical data of the two groups were collected and compared,including age,gender,disease course,body mass index,smoking history,previous pulmonary disease history,classification of tuberculosis treatment,main clinical symptoms,laboratory test results,imaging test results,etc.Logistic regression model was used to analyze the risk factors of respiratory failure in elderly patients with pulmonary tuberculosis.Results:The proportion of retreated patients in the observation group was 47.0％(47/100),significantly higher than that in the control group's 29.1％(32/110)(x2=7.159,P=0.007);the levels of white blood cell count and procalcitonin were(11.50±2.63)×109/L and(0.71±0.25)μg/L,significantly higher than those in the control group((4.62±2.41)×109/L and(0.29±0.17)μg/L),the differences were statistically significant(t values were 19.782 and 14.347,respectively,both P＜0.001).The serum albumin level in the control group was(31.37±7.56)g/L,significantly higher than that in the observation group((24.61±6.72)g/L)(t=6.821,P＜0.001).Multivariate logistic regression analysis showed that retreated pulmonary tuberculosis(OR(95％CI)=1.262(1.151-1.968)),elevated serum white blood cell count levels(OR(95％CD=2.268(1.278-3.343)),elevated procalcitonin levels(OR(95％CI)=1.751(1.408-3.513)),and decreased serum albumin levels(OR(95％CI)=0.893(0.762-0.969))were independent risk factors for respiratory failure in elderly pulmonary tuberculosis patients.Conclusion:Retreated pulmonary tuberculosis,increased white blood cell count and procalcitonin levels,and decreased serum albumin levels are independent risk factors for respiratory failure in elderly patients with pulmonary tuberculosis.Clinical physicians should be vigilant against these factors and take effective treatment measures to reduce the incidence of respiratory failure in elderly patients with pulmonary tuberculosis.
周雪;何芳;狄奕成;张铮;刘菊
中国人民解放军东部战区总医院干部病房二科呼吸内科病区,南京 210000江苏省溧阳市人民医院传染科,常州 213300
临床医学
结核,肺呼吸障碍肺通气老年人危险因素
Tuberculosis,pulmonaryRespiration disordersPulmonary ventilationAgedRisk factors
《中国防痨杂志》 2024 (003)
357-361 / 5
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