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目的分析哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者的致死原因。方法纳入2006年1月至2015年10月收治的哮喘与ACOS患者,其中哮喘患者348例,ACOS患者145例。通过病历记录获得患者信息,进行回顾性研究。基于不同结局分为两组以及FEV1%pred分为三组,分析对比其基本特征以及致死原因,对连续性数据采用t检验,离散型数据采用2检验或Fish精确检验。结果不同结局的患者在年龄(t=3.457,P<0.001),性别(x~2=15.394,P<0.001)和烟龄(x~2=12.418,P=0.002)等方面,其差异有统计学意义。对于ACOS患者,不同结局患者数量差异有统计学意义(x~2=7.033,P=0.008),ACOS患者死亡率显著高于哮喘患者,男性ACOS患者的人数偏高,占86%。恶性肿瘤是导致ACOS患者死亡的主要原因,45%患者死于恶性肿瘤;其次是肺炎,约26%;第三是心血管疾病,占16%。FEV1%pred分组结果显示,当FEV1%pred≥50%,恶性肿瘤是引起ACOS患者死亡的最主要原因;当FEV1%pred<50%,肺炎感染是引起患者死亡的主要原因,但是三组患者致死原因比较,差异无统计学意义(P=0.318)。结论恶性肿瘤是引起ACOS患者死亡最主要的原因,其次是肺炎和心血管疾病。
Objective To analyze the cause of death in patients with asthma - chronic obstructive pulmonary disease overlap syndrome (ACOS). Methods A total of 348 patients with asthma and ACOS were enrolled from January 2006 to October 2015, and 145 patients with ACOS were included. Patient information was obtained through medical records and retrospectively studied. The patients were divided into two groups based on different outcomes and FEV1% pred was divided into three groups. The basic characteristics and cause of death were analyzed and compared. The t-test was used for the continuous data and the 2 test or Fish exact test was used for the discrete data. Results There were statistically significant differences in age (t = 3.457, P <0.001), sex (x 2 = 15.394, P <0.001) and smoking age (x 2 = 12.418, P = 0.002) Significance of learning. For ACOS patients, the number of patients with different outcome was significantly different (x ~ 2 = 7.033, P = 0.008). The mortality rate of ACOS patients was significantly higher than that of asthma patients. The number of ACOS patients was high, accounting for 86%. Malignancy is the leading cause of death in patients with ACOS, 45% of patients died of malignancy; followed by pneumonia, about 26%; the third is cardiovascular disease, accounting for 16%. FEV1% pred group results showed that when FEV1% pred≥50%, malignant tumor is the most important cause of death in patients with ACOS; when FEV1% pred <50%, pneumonia infection is the main cause of death in patients, but the three groups of patients died The reasons were not statistically different (P = 0.318). Conclusions Malignant tumors are the most common cause of death in patients with ACOS, followed by pneumonia and cardiovascular disease.