老年慢性阻塞性肺疾病急性加重期合并衰弱患者血气分析、微炎症指标及肺功能分级、衰弱程度与预后的相关性OACSTPCD
Correlation between Blood Gas Analysis,Micro-inflammation Index,Pul-monary Function Grade,Frailty Degree and Prognosis in Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Com-plicated with Frailty
目的 分析老年慢性阻塞性肺疾病(COPD)急性加重期合并衰弱患者血气分析指标、微炎症指标及肺功能分级、衰弱程度与预后的相关性.方法 选择2021 年1 月—2022 年1 月收治的106 例老年COPD急性加重期合并衰弱患者作为研究对象,根据预后分为死亡组与存活组,比较 2 组临床资料,采用多因素Logistic回归分析血气分析、微炎症指标及肺功能分级、衰弱程度与老年COPD急性加重期合并衰弱患者预后的相关性.结果 2 组肺功能分级及格列宁根衰弱指标(GFI)评分比较差异有统计学意义(P＜0.01),死亡组第 1 秒用力呼气容量占用力肺活量比值、第1 秒用力呼气容量占预计值百分比、氧合指数(OI)、血氧饱和度(SaO2)、动脉血氧分压(PaO2)低于存活组,肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-8(IL-8)明显高于存活组(P＜0.05,P＜0.01).经多因素Lo-gistic回归分析显示,OI、SaO2、PaO2、CRP、TNF-α、IL-8、肺功能分级、GFI评分与老年COPD急性加重期合并衰弱患者预后有密切关系(P＜0.05).结论 老年COPD急性加重期合并衰弱患者血气分析指标、微炎症指标、肺功能分级及衰弱程度与其预后具有密切关系,临床应重点关注上述指标,早期给予针对性处置措施,对于改善老年COPD急性加重期合并衰弱患者预后具有重要意义.
Objective To analyze the correlation between blood gas analysis,micro-inflammation index,pulmonary function grade,frailty degree and prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated with frailty.Methods In total,106 elderly patients with acute exacerbation of COPD combined with frailty treated from January 2021 to January 2022 were selected as research subjects and divided into death group and survival group according to prognosis.The clinical data of the two groups were compared and multivariate Logistic regression analysis was performed to analyze the correlation of blood gas analysis,micro-inflammation index,pulmonary function grade and frailty degree with prognosis in elderly patients with acute exacerbation of COPD complicated with frailty.Results There was signifi-cant difference in pulmonary function grade and Groningen frailty indicator(GFI)score between the two groups(P＜0.01).The ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),the percentage of forced expira-tory volume in the first second to the predicted value(FEV1%),oxygenation index(OI),blood oxygen saturation(SaO2)and arterial partial oxygen pressure(PaO2)in the death group were lower than those in the survival group.Tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-8(IL-8)were significantly higher than those in survival group(P＜0.05,P＜0.01).Multivariate Logistic regression analysis showed that OI,SaO2,PaO2,CRP,TNF-α,IL-8,pulmona-ry function grade and GFI score were closely related to the prognosis of elderly patients with acute exacerbation of COPD com-bined with frailty(P＜0.05).Conclusion The blood gas analysis index,micro-inflammation index,pulmonary function grade and frailty degree of elderly patients with acute exacerbation of COPD combined with frailty are closely related to their prognosis.Clinical attention should be paid to the above indicators in these patients,and early targeted treatment measures are of great significance for improving the prognosis of elderly patients with acute exacerbation of COPD combined with frailty.
冯晋平;令狐红霞
042300 山西 临汾,临汾市中心医院老年医学科
临床医学
肺疾病,慢性阻塞性急性加重期衰弱老年人氧合指数C反应蛋白预后相关性
Pulmonary disease,chronic obstructiveAcute exacerbation stageFrailtyElderlyOxygenation indexC reactive proteinPrognosisCorrelation
《临床误诊误治》 2024 (007)
32-36 / 5
山西省卫生健康委科研课题(2021157)
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