ARDS病例中氧合指数与SPO_2/FiO_2的比较观察  被引量:9

ARDS病例中氧合指数与SPO_2/FiO_2的比较观察

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作  者:卢树标[1] 梁振宇[2] 吴碧彤[3] 刘涓涓[4] 叶文慧[5] 陈晓云[6] 李志军[7] 黄森权 李敏雄[9] 潘女好 李志波[11] 付亮[12] 

机构地区:[1]广东省佛山市顺德区第一人民医院呼吸内科,528300 [2]南方医科大学附属南方医院呼吸内科,510515 [3]广州市胸科医院呼吸内科,512295 [4]惠州市中心人民医院呼吸内科,516001 [5]南方医科大学附属珠江医院呼吸内科,510282 [6]江门市新会区人民医院呼吸内科,529100 [7]中山大学附属第五医院,510000 [8]珠海市香洲区人民医院,519000 [9]佛山市高明区人民医院,528500 [10]佛山市顺德区桂洲医院,528335 [11]中山市陈星海医院,528415 [12]深圳市第三人民医院,518020

出  处:《中国社区医师(医学专业)》2010年第12期135-136,共2页

摘  要:目的:探讨急性呼吸窘迫综合征(ARDS)患者的氧合指数与SPO2/FiO2之间的关系。方法:回顾性采集模型组140例患者及验证组92例患者,对应地采集SPO2/FiO2(≤97%,PEEP≤5cmH2O)及PaO2/FiO2。两组患者分别采用相关检验中的spearman检验来了解SPO2/FiO2与PaO2/FiO2的相关性,采用linearregression求出其两者的线性方程,然后用受试者工作特征曲线(ROC)检验SPO2/FiO2对ARDS的诊断效能。结果:在模型组140例病例156对数据中,氧合指数与SPO2/FiO2的关系方程为SPO2/FiO2=73+0.946×OI[P<0.000;r=0.878]。当SPO2/FiO2=262mmHg相当于氧合指数=200mmHg,验证组92例病例118对数据中氧合指数与SPO2/FiO2亦存在相类似的线性关系,以SPO2/FiO2=262mmHg为判定阈值时,敏感性为90.12%,特异性为86.49%。使用ROC曲线对SPO2/FiO2对ARDS的诊断能力进行检验,模型组曲线下面积为0.876,验证组曲线下面积为0.941。结论:在ARDS患者病情监测中,SPO2/FiO2在一定程度可替代氧合指数。Objective:To investigate the relation between oxygenation index and SPO2/ FiO2 in the patients with ARDS. Methods: Corresponding measurements of SPO2 and PaO2 from patients with ARDS trial of a lower tidal volume ventilator strategy ( n = 140 ) were compared to determine the relationship between S/F and P/F. S/F threshold values correlating with P/F ratios of 200 (ARDS) were determined. Similar measurements from patients enrolled in the trial of lower positive end - expiratory pressure ( n = 92 ) were utilized for validation. Receiver operator characteristic(ROC) curves were plotted to assess the degree of discrimination between S/F and P/F ratios. Results:in the derivation data set( 156 measurements), the relationship between S/F and P/F was described by the following equation: S/F = 73 +0.946×OI[P〈0.000;r=0.8781.An S/F ratio of 262 corresponded with a P/F ratio of 200, The validation database ( 118 measurements) produced a similar linear relationship. The S/F ratio threshold values of 262 resulted in 90.12% sensitivity with 86. 49% specificity for P/F ratios of 200. respectively,AUC for Derivation Data Set and Validation Data Set was(O. 876vs0. 941 ). Conclusion:SPO2/FiO2 to a certain extent, can be used as an alternative data for the oxygenation index to diagnose ARDS.

关 键 词:急性呼吸窘迫综合征 氧合指 数SPO2/FiO2 比较 

分 类 号:R722.135[医药卫生—儿科]

 

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