动脉血氧分压和一氧化碳弥散量占预计值百分比对急性肺栓塞患者短期预后的预测价值  

Predictive value of arterial partial oxygen pressure and carbon monoxide dispersion in percentage of predicted value for short-term prognosis of patients with acute pulmonary embolism

作　　者：季永华 钱文霞[2] 钱宇杰 JI Yonghua;QIAN Wenxia;QIAN Yujie(Department of Respiratory Medicine,the Fifth People's Hospital of Zhangjiagang,Suzhou Jiangsu 215600,China)

机构地区：[1]张家港市第五人民医院呼吸内科,江苏苏州215600 [2]苏州大学附属张家港医院呼吸内科,江苏苏州215600

出　　处：《中国急救复苏与灾害医学杂志》2023年第12期1615-1618,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2021年江苏省卫生健康委医学科研立项项目(编号:H2021007)。

摘　　要：目的探讨动脉血氧分压(PaO_(2))和一氧化碳弥散量占预计值百分比(DLCO%pred)预测急性肺栓塞(APE)患者短期预后的临床价值。方法回顾性分析2021年6月—2023年2月张家港市第五人民医院收治的140例APE患者的临床资料,根据确诊30 d内生存情况分为存活组和死亡组。比较两组患者一般临床资料、PaO_(2)、DLCO%pred差异。采用二元Logistic回归分析建立PaO_(2)、DLCO%pred联合预测APE患者预后预测模型,并绘制受试者工作特征(ROC)曲线,比较PaO_(2)、DLCO%pred单独和联合预测APE患者预后的效能。结果140例APE患者在确诊后30 d内死亡19例,病死率为13.57%。死亡组患者平均年龄、心率、血浆D-二聚体水平均显著高于存活组,收缩压、舒张压、PaO_(2)和DLCO%pred均显著低于存活组(P<0.05)。二元Logistic回归分析发现年龄、心率、收缩压、血浆D-二聚体水平、PaO_(2)和DLCO%pred等6个因素可纳入APE患者确诊后30 d内死亡预测模型建立。ROC曲线分析显示,PaO_(2)的曲线下面积(AUC)为0.901(95%CI:0.842~0.960),DLCO%pred的AUC为0.887(95%CI:0.825~0.950),PaO_(2)+DLCO%pred的AUC为0.930(95%CI:0.889~0.971),PaO_(2)+DLCO%pred预测APE患者30 d内是否死亡的效能更高。结论PaO_(2)和DLCO%pred对APE患者确诊后30 d内预后预测具有良好的临床价值,操作简单、准确性好,二者联合评估效果更好。Objective Arterial partial pressure of oxygen(PaO_(2))and percentage of carbon monoxide dispersion to predicted value(DLCO%pred)were discussed to predict Acute Pulmonary Embolism.The clinical value of short term prognosis in patients with APE.Methods The clinical data of 140 patients with APE admitted to Zhangjiagang Fifth People's Hospital from June 2021 to February 2023 were retrospectively analyzed,and they were divided into survival group and death group according to their survival within 30 days after diagnosis.The differences of general clinical data,PaO_(2),DLCO%pred between the two groups were compared.Logistic regression analysis was used in the second hospital to establish the predictive model of prognosis of APE patients combined with PaO_(2) and DLCO%pred,and the Receiver Operating Characteristic(ROC)curve was compared was drawn.The prognostic efficacy of PaO_(2) and DLCO%pred alone and combined in patients with APE.Results Among 140 APE patients,19 died within 30 days after diagnosis,the mortality rate was 13.57%.The mean age,heart rate and plasma D-dimer level in death group were significantly higher than those in survival group,while systolic blood pressure,diastolic blood pressure,PaO_(2) and DLCO%pred in death group were significantly lower than those in survival group(P<0.05).Binary Logistic regression analysis showed that six factors,including age,heart rate,systolic blood pressure,plasma D-dimer level,PaO_(2) and DLCO%pred,could be included in the death prediction model of APE patients within 30 days after diagnosis.ROC curve analysis showed that the area under curve(AUC)of PaO_(2) was 0.901(95%CI:0.842-0.960),and the AUC of DLCO%pred was 0.887(95%CI:0.825-0.950),the AUC of PaO_(2)+DLCO%pred was 0.930(95%CI:0.889-0.971),and PaO_(2)+DLCO%pred had higher efficacy in predicting death within 30 days in APE patients.Conclusion PaO_(2) and DLCO%pred have good clinical value in predicting the prognosis of APE patients within 30 days after diagnosis.The operation is simple and the accuracy is good.The

关 键 词：急性肺栓塞 动脉血氧分压 一氧化碳弥散量占预计值百分比 预后 预测 

分 类 号：R563.5[医药卫生—呼吸系统]