灌注指数作为足月儿脓毒性休克患儿血管活性药物需求预测指标的评估  

Effect of perfusion index in the prediction of vasoactive drug demands in term infants with septic shock

作　　者：刘雪琴 张卫星 沈洁 刘玉霞 唐成和[2] LIU Xueqin;ZHANG Weixing;SHEN Jie;LIU Yuxia;TANG Chenghe(Neonatal Intensive Care Unit,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院,新乡医学院第四临床学院,河南新乡453000 [2]新乡医学院第一附属医院,河南新乡453100

出　　处：《实用医学杂志》2021年第19期2477-2481,共5页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191319,2018020926)。

摘　　要：目的评估灌注指数(perfusion index,PI)在预测新生儿脓毒性休克患儿早期复苏过程中血管活性药物需求的作用。方法选择新乡市中心医院2018年1月至2020年06月入住新生儿重症监护室(neonatal intensive care unit,NICU)的诊断为新生儿脓毒性休克的病例56例,均为足月儿,根据是否需要使用血管活性药物分为血管活性药物组和非血管活性药物组,需要血管活性药物的有31例,不需要使用血管活性药物的病例有25例。结果(1)PI预测血管活性药物需求的临界值为0.28,灵敏度为90.3%,特异性为96%,AUC为0.96(95%CI:0.91~1.00;P<0.001);(2)动脉血乳酸预测升压药需求的临界值为5.45 mg/dL,灵敏度为74.2%,特异性为92%,AUC为0.89(95%CI:0.81~0.97;P<0.001);(3)其他灌注变量不能预测严重脓毒性休克患儿血管活性药物的需求。结论PI和动脉血乳酸水平可以很好地预测足月儿脓毒性休克患儿是否需要使用血管活性药物。Objective with septic shockfor vasoactive drugs during early recovery.MethodsA total of 56 term infants with neonatal septic shock hospitalized in the neonatal intensive care unit(NICU)of Xinxiang Center Hospital from January 2018 to June2020 were divided into vasoactive drug group(n=31)and non-vasoactive drug group(n=25)according to the need to use vasoactive drugs.Results(1)The cut-off value of PI in predicting the neonates′vasoactive demands was0.28,the sensitivity andthe specificity were 90.3%and 96%,respectively and the AUC was 0.96(95%CI:0.91~1.00;P<0.001).(2)The cut-off value of the arterial lactate level in predicting their vasoactive demands was 5.45 mg/dL,the sensitivity and specificity were 74.2%and 92%,respectively and the AUC was 0.89(95%CI:0.81~0.97;P<0.001).(3)Other perfusion variables failed to predict their vasoactive demands in the septic shock infants.ConclusionPI and arterial lactate levels can predict the demands in septic shock infants for vasoactive drugs.

关 键 词：灌注指数 脓毒性休克 足月儿 血管活性药物 动脉血乳酸 新生儿重症监护室 

分 类 号：R320.34[医药卫生—人体解剖和组织胚胎学]