血清sICAM-1水平联合国家早期预警评分对重症肺炎所致ARDS患者预后的评估价值  

Value of serum sICAM-1 combined with NEWS in assessing prognosis of patients with ARDS due to severe pneumonia

作　　者：张鸥 周峰[2] 周祥林 陆晓鹏 吴萍[1] ZHANG Ou;ZHOU Feng;ZHOU Xianglin;LU Xiaopeng;WU Ping(Department of Critical Medicine,Aoyang Hospital Affiliated to Jiangsu University,Suzhou 210031,China;不详)

机构地区：[1]江苏大学附属澳洋医院重症医学科,江苏苏州210031 [2]江苏大学附属医院急诊科

出　　处：《山东医药》2023年第22期13-16,共4页Shandong Medical Journal

基　　金：江苏省卫生健康委度医学科研项目(JH19019)。

摘　　要：目的探讨血清可溶性细胞间黏附分子-1(sICAM-1)水平联合国家早期预警评分(NEWS)对重症肺炎(SP)所致急性呼吸窘迫综合征(ARDS)患者预后的评估价值。方法选取121例SP所致的ARDS患者,治疗28 d后电话或门诊随访,根据存活情况分组。检测血清sICAM-1水平并计算NEWS。采用多因素Logistic回归分析SP所致ARDS患者死亡的影响因素,采用受试者工作特征(ROC)曲线分析血清sICAM-1水平和NEWS对SP所致ARDS患者死亡的评估价值。结果28 d后随访,死亡37例(死亡组),死亡率为30.58%(37/121),存活84例(存活组)。与存活组比较,死亡组血清sICAM-1水平升高和NEWS增加(P均<0.05)。多因素Logistic回归分析结果显示,sICAM-1(OR=1.004,95%CI:1.002~1.007)、NEWS(OR=2.163,95%CI:1.374~3.405)为SP所致ARDS患者死亡的独立危险因素,氧合指数(OR=0.963,95%CI:0.939~0.988)为独立保护因素(P均<0.05)。ROC曲线分析显示,血清sICAM-1联合NEWS[曲线下面积(AUC)=0.883,95%CI:0.812~0.934]评估SP所致ARDS患者死亡的AUC大于sICAM-1(AUC=0.783,95%CI:0.699~0.853)、NEWS(AUC=0.797,95%CI:0.715~0.865)单独评估(P均<0.05)。结论血清sICAM-1水平和NEWS与SP所致ARDS患者预后相关,血清sICAM-1联合NEWS评估SP所致ARDS患者死亡的价值较高。Objective To investigate the value of serum soluble intercellular adhesion molecule-1(sICAM-1)level combined with National Early Warning Score(NEWS)in assessing the prognosis of patients with acute respiratory distress syndrome(ARDS)due to severe pneumonia(SP).Methods Totally 121 patients with ARDS due to SP were selected and divided into the death group and survival group according to whether they died at 28 d.Serum sICAM-1 levels were measured and NEWS scores were calculated.Multi-factor Logistic regression was used to analyze the factors affecting death in patients with ARDS due to SP,and ROC curves were used to analyze the predictive value of serum sICAM-1 levels and NEWS scores on death in patients with ARDS due to SP.Results They were followed up after 28 days,37 cases died(death group),the mortality rate was 30.58%(37/121),and 84 cases survived(survival group).Compared with the survival group,the serum sICAM-1 level and NEWS scores increased in the death group(all P<0.05).Multi-factor Logistic regression analysis showed that sICAM-1(OR=1.004,95%CI:1.002 to 1.007)and NEWS score(OR=2.163,95%CI:1.374 to 3.405)were independent risk factors for death in SP-induced ARDS patients,and oxygenation index(OR=0.963,95%CI:0.939 to 0.988)was an independent protective factor(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sICAM-1 combined with NEWS score(AUC=0.883,95%CI:0.812 to 0.934)in predicting death in patients with ARDS due to SP was greater than those of sICAM-1(AUC=0.783,95%CI:0.699 to 0.853)or NEWS score(AUC=0.797,95%CI:0.715 to 0.865)alone(both P<0.05).Conclusion Serum sICAM-1 and NEWS scores were independently associated with the prognosis of patients with ARDS due to SP,and serum sICAM-1 combined with NEWS scores were of high value in predicting death in patients with ARDS due to SP.

关 键 词：重症肺炎 急性呼吸窘迫综合征 可溶性细胞间黏附分子-1 国家早期预警评分 预后 

分 类 号：R563.1[医药卫生—呼吸系统]