目的 在四种合并症评分系统中初步筛选出与慢性阻塞性肺疾病急性加重（AECOPD）合并呼吸衰竭患者住院期间病死率密切相关合并症。方法 回顾性观察性研究方法，收集本院急危重症医学科210例AECOPD合并呼吸衰竭患者的临床资料，记录Charlson合并症指数、Elixhauser合并症指数，COTE指数及COMCOLD指数包含的合并症，根据患者生存状态分生存组和死亡组，使用Logistic回归分析筛选与短期预后相关合并症。结果 单因素分析结果显示年龄、心肌梗死、充血性心力衰竭、痴呆、结缔组织病、糖尿病伴有器官损害、中度/重度肾脏疾病、肺纤维化、营养缺乏性贫血、心房颤动/心房扑动差异有统计学意义（P<0.05），多因素Logistic回归分析结果显示充血性心力衰竭（OR=3.821，95%CI：1.518~9.619），痴呆（OR=4.569，95%CI：1.237~16.877），糖尿病伴有器官损害（OR=6.842，95%CI：1.588 ~ 29.484），中度/重度肾脏疾病 （OR=3.274，95%CI：1.141~9.392）是预后相关独立危险因子。结论 与AECOPD合并呼吸衰竭患者住院病 死率相关合并症中，充血性心力衰竭、痴呆、糖尿病伴有器官损害、中度/重度肾脏疾病可能是独立危险因子。

Objective To preliminary screen comorbidities related to short⁃term prognosis of patients with AECOPD and respiratory failure in four comorbidity scoring systems. Methods A retrospective observational study of the clinical data of 210 AECOPD patients with respiratory failure in our hospital was conducted. The comor⁃ bidities included in the Charlson comorbidity index，Elixhauser comorbidity index，COTE index and COMCOLD index were recorded. According to the survival status of patients during the hospitalization，they were divided into survival group and death group. Logistic regression was used to screen out comorbidities related to the prognosis of patients. Results Univariate analysis showed that age，myocardial infarction，congestive heart failure，dementia， rheumatic disease，diabetes mellitus with end⁃organ damage，moderate/severe kidney disease，pulmonary fibrosis， deficiency anemia and atrial fibrillation/flutter were statistically significant（P < 0.05）. Multivariate logistic regres⁃ sion analysis showed that congestive heart failure（OR = 3.821，95%CI：1.518 ~ 9.619）and dementia（OR = 4.569， 95%CI：1.237 ~ 16.877），diabetes mellitus with end⁃organ damage（OR = 6.842，95%CI：1.588 ~ 29.484），and moderate/severe kidney disease（OR = 3.274，95% CI：1.141 ~ 9.392）were independent risk factors related to prognosis. Conclusion Among the comorbidities associated with short⁃term prognosis in patients with respiratory failure due to AECOPD，congestive heart failure，dementia，diabetes mellitus with end⁃organ damage and moder-ate/severe kidney disease may be independent risk factors.