标题：老年多器官功能不全综合征465例危险因素分析

      作者：赵志锐 1，王慧娟 2，张 鑫 1，郭 超 3，解立新 1
    (1.中国人民解放军总医院呼吸科，北京 100853；
2.北京朝阳医院呼吸科，北京 100020；
3.阜外心血管病医院，北京 100037)

      卷次： 2014年25卷22期

      【摘要】 目的 通过分析老年多器官功能不全综合征(MODSE)患者的临床特征，以了解影响患者预后的危
险因素。方法 研究共纳入465例MODSE患者并录入相应的各项临床指标，根据28 d病死率分为生存组和死
亡组，对单因素Logistic回归分析两组间差异有统计学意义的指标进行多因素Logistic回归分析，得出影响预
后的危险因素。 结果 生存组患者的平均年龄为(75.90±7.23)岁，小于死亡组的(77.97±6.94)岁，动脉血乳酸浓
度为(1.39±1.10) mmol/L，低于死亡组的(3.15±3.67) mmol/L，功能不全器官数为(2.76±0.87)个，少于死亡组的
(3.73±1.04)个，APACHEⅢ(64.35±24.32)分，低于死亡组的(96.10±29.74)分，以上各项指标间比较差异均有统计学
意义(P<0.05)。经多因素 Logistic回归分析显示，年龄(P=0.009)、动脉血乳酸浓度(P=0.002)、功能不全器官数
(P<0.001)和APACHEⅢ(P<0.001)是MODSE患者死亡的独立危险因素。结论 年龄、动脉血乳酸浓度、功能不
全器官数和APACHEⅢ是MODSE患者死亡的独立危险因素。

      【关键词】 多器官功能衰竭；危险因素；老年人

      【中图分类号】 R442.8 【文献标识码】 A 【文章编号】 1003—6350（2014）22—3293—04


Risk factors analysis of 465 cases of multiple organ dysfunction syndrome in the elderly.
ZHAO Zhi-rui 1, WANG
Hui-juan 2, ZHANG Xin 1, GUO Chao 3, XIE Li-xin 1. 1. Department of Respiratory Disease, General Hospital of Chinese
PLA, Beijing 100853, CHINA; 2. Department of Respiratory Disease, Beijing Chao-Yang Hospital, Beijing 100020,
CHINA; 3. Department of Cardiovascular Disease, Fu Wai Hospital, Beijing 100037, CHINA

【Abstract】 Objective To analyze the prognostic risk factors of patients with multiple organ dysfunction syn-
drome in the elderly (MODSE) by analyzing their clinical characteristics. Methods In this study, the clinical data of
465 patients with MODSE were collected. The patients were divided into two groups, the survival group and the death
group, basing on the 28 d mortality. Multivariable logistic regression analysis was performed on indicators which had
statistically significant differences in the univariate logistic regression analysis. Results Multivariate Logistic regres-
sion analysis showed that the average age of the survival group (75.90±7.23) was younger than that of the death group
(77.97±6.94); the arterial blood lactate concentration of the survival group (1.39±1.10) was lower than that of the death
group (3.15±3.67) mmol/L; the number of organ dysfunction cases of the survival group (2.76±0.87) was less than that
of the death group (3.73±1.04); and the APACHE Ⅲof the survival group (64.35±24.32) was lower than that of the
death group (96.10 ± 29.74); differences between the above indexes were statistically significant. Therefore, age (P=
0.009), arterial blood lactate concentration (P=0.002), numbers of dysfunctional organs (P<0.001) and APACHEⅢ (P<
0.001) were the risk factors of the death for MODSE patients. Conclusion Age, arterial blood lactate concentration,
numbers of dysfunctional organs and APACHEⅢ were all independent risk factors of death for MODSE patients.