不同类型急性呼吸窘迫综合征血管外肺水指数的比较及其相关因素分析  

Comparison of extravascular lung water index between indirect and direct acute respiratory distress syndrome and analysis of related factors

作　　者：郎琴[1,2] 燕海英[1] 梁宗安[2] 

机构地区：[1]四川省医学科学院.四川省人民医院,四川成都610072 [2]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《实用医院临床杂志》2016年第3期95-97,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨肺源性急性呼吸窘迫综合征(ARDSp)及肺外源性急性呼吸窘迫综合征(ARDSexp)患者血管外肺水指数(EVLWI)的异同以及相关因素分析。方法回顾性分析59例ARDSp患者及33例ARDSexp患者的临床资料,比较两组年龄、性别、急性生理学及慢性健康状况评分(acute physiologic and chronic health evaluation,APACHEII)、氧和指数(PO2/Fi O2)、血清白蛋白浓度(albumin,Alb)、呼气末正压(positive end expiratory pressure,PEEP)、血管外肺水指数(extravascular lung water index,EVLWI)和肺血管通透指数(pulmonary vascular permeability index,PVPI)。结果 ARDSp组PO2/Fi O2、APACHEII评分低于ARDSexp组,EVLWI、PVPI高于ARDSexp组(P<0.05)。EVLWI与Pa O2/Fi O2呈负相关,与PVPI、PEEP呈正相关(P<0.01),与其他指标均无相关性(P>0.05)。结论两种不同类型ARDS的EVLWI不同,提示其肺水肿程度不同。Objective To investigate the difference in extravascular lung water index（ EVLWI） between direct acute respiratory distress syndrome（ ARDSp） and indirect acute respiratory distress syndrome（ ARDSexp） and analyze factors related to EVLWI.Methods Clinic data of 59 patients with ARDSp and 33 patients with ARDSexp were retrospectively analyzed.Age,gender,acute physiologic and chronic health evaluation（ APACHEII）,PO2/ Fi O2,serum albumin（ Alb）,positive end expiratory pressure（ PEEP）,EVLWI and pulmonary vascular permeability index（ PVPI） were compared between the two groups. Results PO2/ Fi O2 and APACHEII were lower while EVLWI and PVPI were higher in the ARDSp group than those in the ARDSexp group（ P 〈0. 05）.EVLWI was negatively correlated with Pa O2/ Fi O2 and positively correlated with PVPI and PEEP（ P 0〈. 01） but not correlated with other factors.Conclusion Different levels of EVLWI in two types of ARDS may suggest the different degree of pulmonary edema.

关 键 词：肺源性急性呼吸窘迫综合征 肺外源性急性呼吸窘迫综合征 血管外肺水指数 

分 类 号：R563[医药卫生—呼吸系统]