重症肺炎患者机械通气后临床转归的影响因素

doi:10.3969/j.issn.1671-7171.2021.11.010

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Abstract 【Objective】To explore the influencing factors of clinical outcome in patients with severe pneumonia after mechanical ventilation. 【Methods】A total of 150 patients with severe pneumonia treated in our hospital from January 2018 to January 2020 was divided into good group (n=86) and bad group (n=64) according to the clinical outcome after mechanical ventilation. The data of gender, age, body mass index (BMI), course of disease, blood pressure level [systolic blood pressure (SBP), diastolic blood pressure (DBP)], serum plasminogen activator inhibitor-1 (PAI-1) and other data of the two groups were counted, and the coagulation function indexes [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), D-Dimer (D-D) and fibrinogen (FIB)] were compared between the two groups. Multivariate logistic regression was used to analyze the independent risk factors affecting the clinical outcome of patients with severe pneumonia after mechanical ventilation, and to analyze the correlation between serum PAI-1 and coagulation function indexes and the clinical outcome of patients with severe pneumonia after mechanical ventilation.【Results】There was no significant difference in gender, age, BMI, course of disease, proportion of combined diseases and blood pressure between the two groups (P>0.05); The levels of serum PAI-1, Pt, APTT, TT and D-D in the good group were lower than those in the bad group (P<0.05), and the level of FIB was higher than those in the bad group (P<0.05). Multivariate logistic regression analysis showed that PAI-1 (OR=9.795, 95% CI=1.819~20.256), APTT (OR = 3.256, 95% CI=1.316~8.447), TT (OR=1.896, 95% CI=1.245~9.847), PT (OR=3.958, 95% CI=1.421~14.429), D-D (OR=2.006, 95% CI=1.854~8.136), FIB (OR=4.008, 95% CI=1.923~11.125) were independent risk factors affecting the clinical outcome of patients with severe pneumonia after mechanical ventilation (P<0.05). Correlation analysis showed that PAI-1, APTT, TT, Pt and D-D were positively correlated with the clinical outcome of patients with severe pneumonia after mechanical ventilation (P<0.05), and negatively correlated with FIB (P<0.05). 【Conclusion】The clinical outcome of patients with severe pneumonia after mechanical ventilation is closely related to serum PAI-1 and coagulation function, which is helpful to judge the prognosis of patients.

Key words： Pneumonia Ventilators, Mechanical Prognosis Root Cause Analysis

Received: 26 September 2021

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R563.1

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	ZHAN Yuan-chang
	WANG Ping

Cite this article:

ZHAN Yuan-chang,WANG Ping. Influencing Factors of Clinical Outcome in Patients with Severe Pneumonia after Mechanical Ventilation[J]. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1635-1638.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.11.010 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I11/1635

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