慢性阻塞性肺疾病急性加重期患者死亡相关危险因素分析

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1、授予单位代码10089学号或申请号13170%‘uV妗(E科大爻HebeiMedicalUniversity硕士学位论文在职科学学位慢性阻塞性肺疾病急性加重期患者死亡相关危险因素分析学位申请人：蒋菊导师：袁雅冬教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大

2、学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。研究生签名导师签_P二级学院领导盖章p/r年z月河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名：我为导师签Pit年Z月/日目录中文摘要······························································

3、···············1英文摘要·············································································2研究论文慢性阻塞性肺疾病患者死亡相关危险因素分析前言·············································································4材料与方法····························································

4、········4结果·············································································7附图·············································································13附表·············································································15讨论··············

5、·······························································23结论·············································································30参考文献·······································································31综述支气管哮喘-慢性阻塞性肺疾病重叠综合征·······················

6、···37致谢···················································································45个人简历·············································································46中文摘要慢性阻塞性肺疾病急性加重期患者死亡相关危险因素分析摘要目的：探讨慢性阻塞性肺疾病急性加重期(AECOPD)住院患者死亡相关危险因素，以便在临床治疗过程中及早进行干预，提高患者的

7、生活质量，降低慢阻肺的病死率。方法：采用回顾性分析方法，收集河北医科大学第二医院2005年至2014年10年期间慢性阻塞性肺疾病急性加重期住院患者共计4624例的资料，根据患者的存活状态，分为死亡组和非死亡组。应用Epidata3.1建立数据库数据，采用双人录入进行核对，采用spss19.0进行统计分析，检验水准α为0.05。采用t检验、卡方检验(2X检验)和Logistic回归模型进行单因素和多因素分析。结果：死亡相关危险因素有(由OR值由高到低)：PCO2、并发症及合并症、机械通气、支持治疗、肺功能等级、PO2、肺部感染、急

8、性发作次数、病程长短、BMI值、年龄等。主要的并发症及合并症包括：肺炎(68.2%)，冠心病(49.7%)，肺心病(47.8%)，心力衰竭(38.2%)，高血压(36.9%)，心律失常(26.8%)，糖尿病(15.9%)，支气管哮喘(12.1%)，急性心梗(10