血管外肺水指数联合肺血管通透性指数在预测脓毒症致急性呼吸衰竭综合征患者预后中的价值分析  

The Value of Extravascular Lung Water Index Combined with Pulmonary Capillary Permeability Index in Predicting Prognosis of Patients with Acute Respiratory Failure Syndrome Induced by Sepsis

作　　者：许文娟 韩从华 陈咏梅 徐进林 吴振华 XU Wenjuan;HAN Conghua;CHEN Yongmei;XU Jinlin;WU Zhenhua

机构地区：[1]长江大学附属仙桃市第一人民医院,湖北仙桃433000

出　　处：《中国医学创新》2020年第1期136-139,共4页Medical Innovation of China

摘　　要：目的:分析血管外肺水指数(EVLWI)联合肺血管通透性指数(PVPI)在预测脓毒症致急性呼吸衰竭综合征(ARDS)患者预后的价值。方法:选取2016年6月-2018年12月在本院住院治疗的63例脓毒症致ARDS患者,根据28 d疾病转归情况分为病死组(n=27)和存活组(n=36)。比较两组治疗前后EVLWI、PVPI、氧合指数(OI)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)及感染相关器官功能衰竭评分系统(SOFA)评分。分析EVLWI、PVPI与OI、APACHEⅡ及SOFA评分的相关性。采用ROC曲线分析EVLWI、PVPI、EVLWI联合PVPI预测脓毒症致ARDS患者预后的价值。结果:治疗前,两组EVLWI、PVPI、OI、APACHEⅡ及SOFA评分比较,差异均无统计学意义(P>0.05);治疗后,存活组EVLWI、PVPI、APACHEⅡ及SOFA评分明显低于病死组,而OI明显高于病死组(P<0.05)。治疗后,存活组EVLWI、PVPI、APACHEⅡ及SOFA评分明显低于治疗前,而OI明显高于治疗前(P<0.05);治疗后,病死组EVLWI、PVPI、APACHEⅡ及SOFA评分明显高于治疗前,而OI明显低于治疗前(P<0.05)。EVLWI、PVPI与OI均呈负相关,而与APACHEⅡ、SOFA评分均呈正相关(P<0.05)。EVLWI联合PVPI的ROC曲线下面积(AUC)最高。结论:EVLWI联合PVPI在预测脓毒症致ARDS患者预后方面具有较高的临床价值。Objective:To analyze the clinical value of extravascular lung water index(EVLWI)combined with pulmonary capillary permeability index(PVPI)in predicting prognosis of patients with acute respiratory failure syndrome(ARDS)induced by sepsis.Method:A total of 63 patients with ARDS caused by sepsis hospitalized in our hospital from June 2016 to December 2018 were selected.They were divided into the death group(n=27)and the survival group(n=36)according to the disease outcome on 28 d.The EVLWI,PVPI,oxygenation index(OI),acute physiology and chronic health evaluation systemⅡ(APACHEⅡ)and sepsis-related organ failure assessment(SOFA)score of two groups before and after treatment were compared.The correlation between EVLWI,PVPI and OI,APACHEⅡ,SOFA score were analyzed.The ROC curve was used to analyze the prognostic value of EVLWI,PVPI and EVLWI combined with PVPI in sepsis induced ARDS patients.Result:Before the treatment,two groups of EVLWI,PVPI,OI,APACHEⅡand SOFA score were compared,there were no statistically significant differences(P>0.05).After treatment,the EVLWI,PVPI,APACHEⅡand SOFA score of the survival group were lower than those in the death group,and OI significantly higher than that in the death group(P<0.05).After treatment,EVLWI,PVPI,APACHEⅡand SOFA score in the survival group were significantly lower than before treatment,and OI was significantly higher than before treatment(P<0.05).After treatment,EVLWI,PVPI,APACHEⅡand SOFA score in the death group were significantly higher than before treatment,and OI significantly lower than before treatment(P<0.05).EVLWI and PVPI were negatively correlated with OI,while with APACHEⅡand SOFA scores were positively correlated(P<0.05).The area under the ROC curve(AUC)of EVLWI combined with PVPI was the highest.Conclusion:EVLWI combined with PVPI has high clinical value in predicting the prognosis of ARDS patients with sepsis.

关 键 词：血管外肺水指数 肺血管通透性指数 脓毒症 急性呼吸衰竭综合征 

分 类 号：R459.7[医药卫生—急诊医学] R563.8[医药卫生—治疗学]