目的 分析影响重症监护室(ICU)重度肺炎合并中重度急性呼吸窘迫综合征(ARDS)患者预后的危险因素。方法 回 顾性分析76例ICU重度肺炎合并中重度ARDS患者临床资料，根据出院时Glasgow临床结局评分将其分为预后良好组 (n=47)和预后不良组(n=29)。采用logistic回归分析影响重度肺炎合并中重度ARDS患者预后质量的独立危险因素。 结果 ①年龄、机械通气时间、ARDS分度、ICU住院时间、记性生理功能和慢性健康状况评分系统Ⅱ(APACHE Ⅱ评 分)及序贯器官衰竭评估(SOFA)评分是重度肺炎合并中重度ARDS患者预后不良的单因素(P均<0.05)；②高龄、重度 ARDS、ICU住院时间短、机械通气时间短、APACHE Ⅱ评分及SOFA评分的增加是造成重度肺炎合并中重度ARDS患者预 后不佳的独立危险因素(P均<0.05)。结论 ICU重度肺炎合并中重度ARDS患者的预后与年龄、机械通气时间、ARDS分 度、ICU住院时间、APACHE Ⅱ评分及SOFA评分等多种危险因素相关。

Objective To analyze the risk factors affecting the prognosis of patients with severe pneumonia complicated with moderate-to-severe acute respiratory distress syndrome (ARDS) in intensive care unit (ICU). Methods The clinical data of 76 patients with severe pneumonia complicated with moderate-to-severe ARDS were retrospectively analyzed. According to Glasgow clinical outcome score at discharge, they were divided into good prognosis group (n=47) and poor prognosis group (n=29). Logistic regression was used to analyze independent risk factors for prognosis quality in patients with severe pneumonia complicated with moderate-to-severe ARDS. Results Age, mechanical ventilation time, ARDS indexing, ICU stay, acute physiology and chronic health evaluation II (APACHE II score) and sequential organ failure assessment (SOFA) score were single factors for poor prognosis of patients with severe pneumonia complicated with moderate-to-severe ARDS (all P<0.05). Advanced age, severe ARDS, short ICU stay, short mechanical ventilation time and increase of APACHE II score and SOFA score were independent risk factors for poor prognosis in patients with severe pneumonia complicated with moderate-to-severe ARDS (all P<0.05). Conclusion The prognosis of patients with severe pneumonia complicated with moderate-to-severe ARDS is related to age, mechanical ventilation time, ARDS indexing, ICU stay, APACHE II score and SOFA score.