摘要
目的:分析主动脉夹层肺损伤的危险因素,以便为其合理防治提供依据。方法:回顾分析2006-02-2011-02期间我院268例主动脉夹层患者,分为肺损伤(+)组[(PaO2/FiO2)≤300]和肺损伤(-)组[(PaO2/FiO2)>300],记录患者的年龄、性别、体质指数、体温、吸烟史、疼痛史;用CT等辅助检查了解:胸腔积液、心包积液、心电图异常、主动脉瓣关闭不全、Standford分型、主动脉夹层累及肠系膜动脉、肾动脉;实验室检测超敏C反应蛋白、D-二聚体、血红蛋白、白细胞、白蛋白、心肌酶、肌酐、动脉血气分析。进行单因素及多因素Logistic回归分析。结果:主动脉夹层并发肺损伤的发生率35.44%(95/268),平均PaO2/FiO2为(324±74),其中肺损伤(+)组PaO2/FiO2为(287±33),肺损伤(-)组PaO2/FiO2为(354±41),单因素分析中有统计学意义的危险因素包括:体温、白细胞、超敏C反应蛋白、主动脉夹层累及双肾动脉或肠系膜上动脉,Logistic回归分析超敏C反应蛋白、白细胞为有意义的独立预测因素。结论:主动脉夹层肺损伤与体温、白细胞、超敏C反应蛋白、累及双肾动脉或肠系膜上动脉相关,其中超敏C反应蛋白>15mg/L、白细胞>14G为独立预测因素。
Objective：To analyze the risk factors of lung injury in aortic dissection and to find strategies for its prevention and management.Method：A retrospective analysis included 268 patients with aortic dissection from February 2006 to February 2011.Patients were divided into lung injury（＋） group（PaO2/FiO2≤300） and lung injury（-） group（PaO2/FiO2300）.Data were recorded including the patient＇s age,gender,body mass index,body temperature,smoking history,pain history,pleural effusion,the pericardial effusion,electrocardiogram abnormalities,aortic insufficiency,Standford Type,the aortic dissection involving renal artery or mesenteric artery,hsCRP,D-dimmers,hemoglobin,leukocyte,albumin,myocardial enzyme,creatinine, arterial blood gas analysis.All the factors were evaluated by means of univariate and multivariate Logistic analysis to identify relative risk factors of lung injury.Result：The incidence of lung injury in aortic dissection was 35.44%（95/268）,average oxygenation index was（324±74）,including lung injury（＋） group（287±33）,lung injury（-） group（354±41）.Single factor analysis of statistically significant risk factors included body temperature,leukocyte, hs-CRP,ischemic of double renal artery or superior mesenteric artery.Logistic regression analysis of meaningful independent predict factors were WBC and hs-CRP.Conclusion：Lung injury of aortic dissection was related to the body temperature,white blood cell,hs-CRP,ischemic of renal artery or superior mesenteric artery.Among them,hs-CRP15,WBC14 were significantly independent predict factors for lung injury.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2012年第1期64-67,共4页
Journal of Clinical Cardiology
关键词
主动脉夹层
肺损伤
炎症
aortic dissection
lung injury
inflammation
