慢性阻塞性肺病急性加重期患者细菌性肺炎危险因素分析-现代医学

慢性阻塞性肺病急性加重期患者细菌性肺炎危险因素分析

单位：亳州市第二中医院肺病科, 安徽亳州 233500

分类号：R563

出版年·卷·期（页码）：2025·53·第十二期（1871-1876）

摘要：

目的：探讨慢性阻塞性肺病急性加重期(AECOPD)患者发生细菌性肺炎的危险因素并构建预测模型。方法：回顾性分析2022年1月至2024年12月期间于亳州市第二中医院住院治疗的153例AECOPD患者的临床资料，根据是否出现细菌性肺炎分为细菌性肺炎组(57例)和非细菌性肺炎组(96例)。通过单因素、多因素Logistic回归分析筛选独立危险因素，并绘制受试者工作特征(ROC)曲线分析预测模型的预测价值。结果：本研究中AECOPD患者细菌性肺炎发生率为37.25%(57/153)。多因素Logistic回归分析结果显示，年龄≥60岁、合并糖尿病、低蛋白血症、长期卧床、住院时间≥7 d及糖皮质激素使用天数≥5 d是AECOPD患者发生细菌性肺炎的独立危险因素(P<0.05)。风险预测模型经ROC曲线验证，结果显示，预测模型ROC曲线下面积(AUC)为0.832(95%CI 0.733~0.931)，敏感度和特异度分别为0.762和0.736。结论： AECOPD患者发生细菌性肺炎风险与年龄、合并糖尿病、长期卧床、糖皮质激素使用时间和住院时间有关，临床可针对相关危险因素采取措施，以降低患者肺炎风险，改善患者预后。

Objective: To explore the risk factors for bacterial pneumonia in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and to construct a predictive model. Methods: Clinical data of 153 AECOPD patients admitted to Bozhou Second Hospital of Traditional Chinese Medicine between January 2022 and December 2024 were retrospectively analyzed. Patients were divided into a bacterial pneumonia group(57 cases) and a non-bacterial pneumonia group(96 cases) according to the presence of bacterial pneumonia. Univariate analysis was performed to compare baseline characteristics, and multivariate Logistic regression analysis was used to identify independent risk factors and construct a prediction model. The predictive performance of the model was evaluated using receiver operating characteristic(ROC) curve analysis. Results: The incidence of bacterial pneumonia among AECOPD patients was 37.25%(57/153). Multivariate Logistic regression analysis showed that age ≥60 years, comorbid diabetes, hypoproteinemia, long-term bed rest, hospital stay ≥7 d, and duration of glucocorticoid use ≥5 d were independent risk factors for bacterial pneumonia in AECOPD patients(P<0.05). The ROC curve analysis yielded an area under the curve(AUC) of 0.832(95% CI 0.733-0.931), with a sensitivity of 0.762 and a specificity of 0.736. Conclusion: The risk of bacterial pneumonia in AECOPD patients is associated with older age, diabetes, long-term bed rest, prolonged glucocorticoid use, and extended hospitalization. Targeted interventions addressing these risk factors may help reduce the incidence of bacterial pneumonia and improve patient outcomes.

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