摘要目的:研究慢性阻塞性肺疾病(COPD)并发脓毒性心肌病的独立危险因素，并通过预测模型评估其临床价值，为临床预防该疾病的发生提供理论指导。方法:收集广元市第一人民医院重症医学科2016-2019年住院治疗的COPD患者143例为研究对象，根据是否并发脓毒性心肌病将其分为观察组(COPD并发脓毒性心肌病，70例)和对照组(COPD未并发脓毒症心肌病，73例)。比较2组临床资料，采用Logistic回归分析COPD并发脓毒性心肌病的独立危险因素，并利用受试者工作特征(ROC)曲线对预测模型进行分析。结果:观察组的平均年龄、吸烟史比例、机械通气比例、合并高血压、糖尿病、高碳酸血症、肾功能异常、低蛋白血症、低镁血症、低钙血症、慢性阻塞性肺疾病全球倡议(GOLD)肺功能分级Ⅰ～Ⅱ级比例均显著高于对照组( P值均<0.05)。Logistic回归分析结果显示，年龄、肾功能异常、低蛋白血症、机械通气、低钙血症、高乳酸血症为COPD并发脓毒性心肌病的独立危险因素( P值均<0.05)。ROC曲线分析可知，其曲线下面积(AUC)最高的为GOLD肺功能分级0.71，最低的为机械通气0.60，敏感度最高的为GOLD肺功能分级88.57%，特异度最高的为年龄98%。多因素联合ROC曲线分析后得出，AUC＝0.922，约登指数＝0.667，敏感度和特异度分别为91.43%和75.34%。 结论:COPD并发脓毒性心肌病的危险因素较多，临床中应加强关注以采取有效措施预防脓毒性心肌病的发生。

abstractsObjective:To study the independent risk factors of chronic obstructive pulmonary disease (COPD) complicated by septic cardiomyopathy, and to evaluate its clinical value through predictive models, and to provide theoretical guidance for clinical prevention of the disease.Methods:Collected 143 COPD patients who were hospitalized in the Department of Critical Care Medicine, Guangyuan First People′s Hospital from 2016 to 2019 as the research objects.They were divided into observation groups according to whether they were complicated by septic cardiomyopathy (COPD with septic cardiomyopathy, 70 cases) and the control group (COPD without septic cardiomyopathy, 73 cases). The clinical data of the two groups were compared, logistic regression was used to analyze the independent risk factors of COPD complicated with septic cardiomyopathy, and the receiver operating characteristic (ROC) curve was used to analyze the predictive model.Results:The average age of observation group, percentage of smoking history, percentage of mechanical ventilation, combined with hypertension, diabetes, hypercapnia, renal dysfunction, hypoproteinemia, hypomagnesemia, hypocalcemia, Global Initiative for Chronic Obstructive Lung Disease (GOLD). The proportion of pulmonary function grading Ⅰ~Ⅱ was significantly higher than that of the control group (all P<0.05). Logistic regression analysis showed that age, abnormal renal function, low egg Leukemia, mechanical ventilation, hypocalcemia, and hyperlactic acidemia are independent risk factors for COPD complicated with septic cardiomyopathy (all P<0.05). ROC curve analysis shows that the highest area under the curve (AUC) is GOLD lung function classification 0.71, the lowest is mechanical ventilation 0.60, the highest sensitivity is GOLD lung function classification 88.57%, and the highest specificity is age 98%.Combined with multi-factor and ROC curve analysis, AUC=0.922, Youden index=0.667, sensitivity and specificity are 91.43% and 75.34%, respectively. Conclusions:There are many risk factors for COPD complicated with septic cardiomyopathy, and more attention should be paid in clinical practice.Take effective measures to prevent the occurrence of septic cardiomyopathy.