老年慢性疾病对肺部感染并发老年多器官功能不全综合征的早期预测价值

Value of chronic diseases for early prediction of pulmonary infection induced multiple organ dysfunction syndrome in the elderly

【摘要】目的研究老年慢性疾病对肺部感染并发老年多器官功能不全综合征(MODSE)的早期预测价值。方法回顾性地分析2001年1月至2006年12月因肺部感染在白求恩国际和平医院住院或住院期间出现肺部感染的驻石家庄地区60岁以上的师以上军队离退休干部393例的病历资料,根据肺部感染是否诱发MODSE将所有病例分为MODSE组和非MODSE组,调查各组所患老年慢性疾病情况。先做单因素分析,采用四格表χ2检验分析2组病例所患各种老年慢性疾病的差异,再选择单因素分析中差异有统计学意义的老年慢性疾病作自变量,以MODSE为因变量,作二分类逐步Logistic回归分析,筛选对肺部感染并发MODSE有影响的老年慢性疾病。结果单因素分析有统计学意义的老年慢性疾病有:慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、肺心病、冠心病、慢性心功能不全、脑血管疾病、颈椎病、慢性肝炎与肝硬化、糖尿病、高尿酸血症、慢性肾功能不全、恶性肿瘤等13种老年慢性疾病。经二分类逐步Logistic回归分析,其中慢性心功能不全、脑血管疾病、慢性阻塞性肺疾病、慢性呼吸衰竭、肺心病、肺间质纤维化、糖尿病、慢性肾功能不全、恶性肿瘤等9种老年慢性疾病为肺部感染并发MODSE的危险因素。结论慢性心功能不全、脑血管疾病、慢性阻塞性肺疾病、慢性呼吸衰竭、肺心病、肺间质纤维化、糖尿病、慢性肾功能不全、恶性肿瘤等老年慢性疾病对肺部感染并发MODSE具有一定的早期预测价值。

基金项目:白求恩国际和平医院"十一五"计划课题(2007044)

【Abstract】Objective To study the value of chronic diseases for early predicrion of pulmonary infection induced multiple organ dysfunction syndrome in the elderly (MODSE). Methods Medical record data from 393 retired veteran cadres aged over 60 years,living in Shijiazhuang region,were analyzed retrospectively,who were hospitalized due to pulmonary infection or suffered pulmonary infection during hospitalization in Bethune International Peace Hospital from January 2001 to December 2006. They were divided into MODSE and non-MODSE groups.χ2 test for fourfold table was used to analyze the difference in morbidity of chronic diseases between the two groups. Binary Logistic stepwise regression model was used to screen the chronic diseases with high risk of MODSE. Results Single factor analysis showed that chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary fibrosis,pulmonary heart disease,coronary heart disease,chronic cardiac insufficiency,cerebrovascular disease,cervical spondylosis,chronic hepatitis and cirrhosis,diabetes,hyperuricemia,chronic renal failure and malignant tumor affected the morbidity of MODSE. Binary Logistic stepwise regression showed that chronic cardiac insufficiency,cerebrovascular disease,chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary heart disease,pulmonary fibrosis,diabetes,chronic renal failure and malignant tumor were the high risk chronic diseases. Conclusion Chronic cardiac insufficiency,cerebrovascular disease,chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary heart disease,pulmonary fibrosis,diabetes,chronic renal failure and malignant tumor are valuable in early prediction of MODSE induced by pulmonary infection.