心脏超声参数及LUS对AECOPD合并呼吸衰竭患者机械通气撤机结局的预测价值  

Predictive Value of Cardiac Ultrasound Parameters and LUS on the Outcome of Mechanical Ventilation withdrawal in Patients with AECOPD and Respiratory Failure

作　　者：常凯悦 李军社 CHANG Kai-yue;LI Jun-she(Department of Infectious Diseases,The Second Hospital of Yulin,Yulin Shaanxi 719000)

机构地区：[1]榆林市第二医院感染性疾病科,陕西榆林719000 [2]宝鸡市陈仓区妇幼保健计划生育服务中心(区妇幼保健院、健康教育中心)普通内科,陕西宝鸡721300

出　　处：《医学临床研究》2023年第4期535-538,共4页Journal of Clinical Research

摘　　要：【目的】探讨心脏超声参数及肺部超声评分(LUS)对慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者机械通气撤机结局的预测价值。【方法】选取2018年5月至2021年3月榆林市第二医院收治的125例AECOPD合并呼吸衰竭患者,统计所有患者机械通气撤机结局,采用Logistic多因素回归分析AECOPD合并呼吸衰竭患者机械通气撤机结局的影响因素;采用受试者工作特征(ROC)曲线下面积(AUC)评估心脏超声参数及LUS对AECOPD合并呼吸衰竭患者机械通气撤机结局的预测价值。【结果】125例AECOPD合并呼吸衰竭患者中有24例撤机失败,剩余101例撤机成功。Logistic多因素分析显示:浅快呼吸指数(RSBI)、LUS、舒张早期左房室瓣血流速度(V_(1))/舒张早期左房室瓣环运动速度(V_(3))是影响AECOPD合并呼吸衰竭患者机械通气撤机结局的独立因素(OR:3.673、4.450、3.442,95%CI:1.511~8.927、1.831~10.816、1.416~8.365,P<0.05)。ROC曲线分析结果显示:LUS、V_(1)/V_(3)及两者联合预测AECOPD合并呼吸衰竭患者机械通气撤机结局的AUC分别为0.776、0.782、0.882。【结论】AECOPD合并呼吸衰竭患者机械通气撤机失败风险较高,心脏超声参数V_(1)/V_(3)、LUS与患者机械通气撤机结局有关,二者联合预测撤机结局效能更好。【Objective】To explore the predictive value of cardiac ultrasound parameters and lung ultrasound score(LUS)on the outcome of mechanical ventilation withdrawal in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.【Methods】A total of 125 patients with AECOPD and respiratory failure admitted to the Second Hospital of Yulin City from May 2018 to March 2021 were selected,and the outcome of mechanical ventilation withdrawal was statistically analyzed for all patients.Logistic multivariate regression analysis was used to analyze the influencing factors of mechanical ventilation withdrawal outcome for AECOPD and respiratory failure patients;The predictive value of cardiac ultrasound parameters and LUS on the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure was evaluated using the area under the subject operating characteristic(ROC)curve(AUC).【Results】Of the 125 patients with AECOPD and respiratory failure,24 failed to wean,while the remaining 101 were successfully weaned.Logistic multivariate analysis showed that shallow rapid respiratory index(RSBI),LUS,and early diastolic left atrioventricular valve flow velocity(V_(1))/early diastolic left atrioventricular annular motion velocity(V_(3))were independent factors affecting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure(OR:3.673,4.450,3.442,95%CI:1.511-8.927,1.831-10.816,1.416-8.365,P<0.05).The results of ROC curve analysis showed that the AUC of LUS,V_(1)/V_(3),and their combination in predicting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure were 0.776,0.782,and 0.882,respectively.【Conclusion】Patients with AECOPD and respiratory failure have a higher risk of mechanical ventilation withdrawal failure.Cardiac ultrasound parameters V_(1)/V_(3) and LUS are related to the outcome of mechanical ventilation withdrawal,and the combination of the two is more effective in predictin

关 键 词：肺疾病 慢性阻塞性/并发症 呼吸功能不全/并发症 肺疾病 慢性阻塞性/影像诊断 呼吸 人工 病人结局评价 

分 类 号：R563[医药卫生—呼吸系统]