【摘要】 目的 探讨慢性阻塞性肺疾病急性加重（AECOPD）患者住院治疗相关危险因素,为患者住院诊疗提供依据。方法 横断面观察研究山西医科大学第一医院门诊的AECOPD患者127例,按治疗情况分为住院治疗组50例,非住院治疗组77例。先对2组可能的因素进行单因素分析,然后对单因素分析中P<0.05的因素进行多因素Logistic逐步回归分析,寻找AECOPD住院治疗的相关危险因素。结果 住院治疗组与非住院治疗组单因素分析的比较中,前1年至少1次急诊住院[70.0%（35/50）比22.1%（17/77）]、化痰治疗[54.0%（27/50）比28.6%（22/77）]、家庭氧疔[42.9%（21/50）比10.4%（8/77）]、前1年急诊入院次数[（2.0±0.3）次比（0.6±0.1）次]、PaO₂[（63±11）mm Hg（1 mm Hg=0.133 kPa）比（71±11）mm Hg]、PaCO₂[（47±9）mm Hg比（43±8）mm Hg]、SaO₂[（91±5）%比（94±3）%]、血红蛋白含量[（141±14）g/L比（149±14）g/L]、白细胞计数[（9.3±2.5）×10⁹/L比（8.1±2.2）×10⁹/L]、BODE（B为体重指数,O为气流阻塞,D为呼吸困难,E为运动能力）指数[（4.9±2.3）比（3.0±2.1）]、6 min步行试验距离[（315±118）m比（431±117）m]差异均有统计学意义（均P<0.05）;多因素Logistic回归分析结果 显示前1年急诊住院次数[比值比（OR）:2.485,95%置信区间（CI）:2.092⁴.019)],BODE指数（OR:3.303,95%CI:3.054⁵.610）,SaO₂（OR:0.658,95%CI:0.561⁰.967）,均为AECOPD患者需住院治疗的独立危险因素。结论 较低的血氧饱和度、较高的BODE指数和前1年多次的急诊入院可能是AECOPD患者需住院治疗的独立危险因素。更多还原

【Abstract】 Objective To investigate the risk factors associated with hospital admission for acute exacerbation of obstructive pulmonary disease（AECOPD）.Methods One hundred and twenty-seven outpatients with AECOPD from the First Hospital of Shanxi Medical University were investigated through a cross-sectional and observational study.They were divided into inpatient treatment group and ambulatory treatment according to treatment.First, we studied the four types of 23 possible factors with single-factor analysis,then the factors with P value below 0.05 in single-factor analysis were proceeded to perform the multiple-factor analysis with logistic regression.We analyzed the risk factors associated with hospital admission for AECOPD.Results The single-factor analysis showed that patients with at least one visit to the hospital emergency room（ER） in the previous year[70%（35/50）vs 22.1%（17/77）], mucolytic cure[54%（27/50） vs 28.6%（22/77）].oxygen therapy[42.9%（21/50） vs 10.4%（8/77）),the number of visits to the ER[（2.0±0.3） vs（0.6±0.1）],PaO₂[（63±11）mm Hg vs（72±11）mm Hg],PaCO₂ [（47±9） mm Hg vs（43±8） mm Hg],SaO₂[（91±5）%vs（94±3）%],Hb[（141±14） g/L vs（149± 14）g/L],WBC[（9.3±2.5） ×10⁹/L vs（8.1±2.2）×10⁹/L],the BODE index[（4.9±2.3） vs（3.0± 2.1）]and 6MWT[（315±118）m vs（431±117）m]were risk factors（P <0.05）.According to the multiple-factor analysis of with Logistic regression analysis,there were 3 factors including the number of visits to the ER（OR: 2.485,95%CI:2.0924.019）,the BODE index（OR:3.303,95%CI:3.054-5.610） and SaO₂（OR:0.658, 95%CI:0.561-0.967）（P<0.05）.Conclusion Low SO₂,high BODE index score and a greater number of visits to the ER may be the independent risk factors of hospital admission for AECOPD patients.更多还原