慢性阻塞性肺疾病合并肺心病患者预后的相关因素分析.doc

慢性阻塞性肺疾病合并肺心病患者预后的相关因素分析 　　作者：唐继红　顾宗元　王磊 　作者单位: 200062 上海，上海中医药大学附属普陀医院呼吸科 　　【摘要】 目的 探讨影响慢性阻塞性肺疾病（COPD）合并肺心病患者预后的相关因素和防治措施。 方法 对170例 CDPD合并肺心病住院患者的预后进行临床分析。 结果 本组资料显示患者年龄越大，病死率越高，80岁以上患者病死率 高达36.11%。COPD病情和右心功能不全越严重，病死率越高。重度COPD和右心功能不全病死率分别为28.89%和 38.78%。患者急性加重次数越多，病死率越高，每年急性加重次数3次者，病死率高达46.0%。患者冬季病死率最高 （57.78%），夏季最少（2.22%）。重度营养不良者，病死率高达68.75%。≥3个合并症者病死率高达62.85%。PaO 2 6.65kPa者病死率高达49.02%。 结论 年龄、病情严重程度、急性加重次数、合并症、营养状况及动脉血气等因素均与 COPD肺心病患者的预后关系密切，在综合治疗的同时，应重视营养支持氧疗。 　　【关键词】 慢性阻塞性肺疾病;肺心病;预后 　　Analysis of the factors related prognosis in the patients with chronic pulmona- ry heart disease with chronic obstuctive pulmonary disease 　　TANG Ji-hong，GU Zong-yuan，WANG Lei. 　　Department of Respiratory Medicine，Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine，Shanghai 200062，China 　　【Abstract】 Objective To explore the factors related prognosis and the measure of prevented and treatment in the patients with chronic pulmonary heart disease（CPHD）with chronic obstructive pulmonary disease （COPD）. Methods Analysis of the prognosis in 170 patients of hospitalization with CPHD with COPD. Results The more patients age，the more patients fatality rate.The fatality rate was 36.11% in the over eighty years old with patients.The more fatality rate，the more severity of the state of illness with COPD and the function with heart.The fatality rate was 28.89% and 38.78% respectively in the serious COPD and heart failure.The more fatality rate，the more acute exacerbation.When the acute exacerbation over three times every year in the pa- tients，the fatality rate was 46.00%.The fatality rate was highest（57.78%）in winter and was low（2.22%） in summer.The fatality rate was 68.75% in the patients with severe malnutrition.The fatality rate was 62.85% in the patients with over three complications.The fatality rate was 49.02% in the patients with PaO 2 6.65kPa. Conclusion