动态血磷水平对老年脓毒症相关性急性肺损伤及急性呼吸窘迫综合征患者近期预后的预测价值  

The value of dynamic blood phosphorus level monitoring in predicting the short-term prognosis of elderly patients with sepsis-related acute lung injury and acute respiratory distress syndrome

作　　者：王晓林[1] 李静 黄艳丽 Wang Xiaolin;Li Jing;Huang Yanli(ICU,First Hospital of Qinhuangdao City,Qinhuangdao,Hebei,066000,P.R.China;Department of Pharmacy,First Hospital of Qinhuangdao City,Qinhuangdao,Hebei,066000,P.R.China)

机构地区：[1]秦皇岛市第一医院ICU,河北秦皇岛066000 [2]秦皇岛市第一医院药学部,河北秦皇岛066000

出　　处：《老年医学与保健》2021年第6期1226-1230,共5页Geriatrics & Health Care

基　　金：秦皇岛市科学技术研究与发展计划项目(201902A195)。

摘　　要：目的研究动态血磷水平对老年脓毒症相关性急性肺损伤及急性呼吸窘迫综合征(ALI/ARDS)患者近期预后的预测价值。方法选择2019年8月—2021年5月于秦皇岛市第一医院ICU收治的老年脓毒症相关性ALI/ARDS患者80例,根据患者28 d预后情况将其分为死亡组和存活组。收集患者一般资料,检测患者进入ICU后1、3、5、7 d的血磷水平,分析影响患者预后的危险因素以及动态血磷水平对患者28 d预后的预测价值,并分析不同血磷水平患者28 d累积生存情况。结果2组性别、疾病类型、年龄、有创机械通气以及ICU住院时间比较差异无统计学意义(P>0.05),但存活组APACHEⅡ评分和动脉血乳酸均明显低于死亡组(P<0.05),而氧合指数高于死亡组(P<0.05);2组入院1 d血磷水平比较差异无统计学意义(P>0.05),但入院3、5和7 d时,存活组血磷水平均显著高于死亡组(P<0.05);APACHEⅡ评分、动脉血乳酸、入院血磷水平是影响患者预后的独立危险因素(P<0.05);ROC曲线显示,入院第7 d时的血磷水平对患者28 d预后的预测AUC值和敏感度最高(P<0.05);高于血磷水平临界值组患者28 d存活率以及生存期均显著高于低于血磷临界值组(P<0.05)。结论老年脓毒症相关性ALI/ARDS患者血磷水平降低,可能是导致其死亡的独立危险因素,动态监测血磷水平变化可作为较好的预后预测指标。Objective To study the value of dynamic blood phosphorus level monitoring in predicting the short-term prognosis of elderly patients with sepsis-related acute lung injury and acute respiratory distress syndrome(ALI/ARDS).Methods A total of 80 elderly patients with sepsis-related ALI/ARDS who were admitted to First Hospital of Qinhuangdao City from August 2019 to May 2021 were selected.According to the 28-day prognosis of patients,they were divided into the death group and survival group.The general data of patients were collected,and the blood phosphorus level was measured at 1,3,5 and 7 days after admission to the intensive care unit(ICU).The risk factors affecting the prognosis of patients and the value of dynamic blood phosphorus level monitoring in predicting the 28 day prognosis of patients were analyzed,and the 28 day cumulative survival of patients with different blood phosphorus levels was analyzed.Results There was no statistically significant difference in gender,disease type,age,invasive mechanical ventilation and length of ICU stay between the two groups(P>0.05),but APACHEⅡscore and arterial blood lactate level of the survival group were lower than those of the death group,and oxygenation index was higher than that of the death group(P<0.05).There was no significant difference in blood phosphorus levels between the two groups at the first day of admission(P>0.05),but the blood phosphorus levels of the survival group were significantly higher than those of the death group at the 3 rd,5 th,and 7 th day of admission(P<0.05).APACHEⅡscore,arterial blood lactic acid and blood phosphorus level at the 3 rd,5 th,and 7 th day of admission were independent risk factors affecting the prognosis of patients(P<0.05).ROC curve showed that the blood phosphorus level at the 7 th day of admission had the highest AUC value and sensitivity for predicting the prognosis of patients at the 28 th day(P<0.05).The 28 day survival rate and survival time of the patients with blood phosphorus level higher than the critical val

关 键 词：老年 脓毒症 急性肺损伤 急性呼吸窘迫综合征 血磷水平 近期预后 

分 类 号：R563[医药卫生—呼吸系统] R459.7[医药卫生—内科学]