脓毒症相关急性呼吸窘迫综合征危险因素分析:一项回顾性队列研究  

Risk Factor Analysis for Sepsis⁃associated Acute Respiratory Distress Syndrome:a Retrospective Cohort Study

作　　者：易小玲 曾国琼 陈慧[1] 顾杨 李莉[1] 余涛[1] YI Xiao-ing;ZENG Guo-qiong;CHEN Hui;GU Yang;LI Li;YU Tao(Department of Emergency medicine,the Sun Yat-sen Memorial Hospital,Guangzhou,Guangdong,510120)

机构地区：[1]中山大学孙逸仙纪念医院急诊科,510000

出　　处：《岭南急诊医学杂志》2024年第4期322-324,361,共4页Lingnan Journal of Emergency Medicine

基　　金：广东省医学科研基金(A2023079);广东省广州市科技计划项目(2024A03J1188)。

摘　　要：目的:多项指标联合构建脓毒症相关急性呼吸窘迫综合征(ARDS)的预测模型。方法:收集2018年3月至2022年10月中山大学孙逸仙纪念医院303例脓毒症患者的临床资料,采用单因素和多因素Logistic回归分析筛选ARDS发生的独立危险因素,构建ARDS发生的预测模型。结果:303例患者中,ARDS组145例,非ARDS组158例,两组在氧合指数、血氧、尿素氮、舒张压、白蛋白、SOFA评分、脓毒性休克、肺部及泌尿系感染等方面具有显著差异(P<0.05)。多因素回归分析示舒张压、白蛋白、氧合指数、肺部感染及脓毒性休克与ARDS发生独立相关。ARDS联合预测模型曲线下面积为0.812(95%CI 0.76-0.86),敏感度为69.7%,特异度为84%。结论:联合指标构建的ARDS预测模型具有较好的预测效能,有助于患者的临床诊治。Objective:To construct a predictive model for sepsis associated-acute respiratory distress syndrome(ARDS)by combining multiple indicators.Methods:We performed a retrospective analysis of the medical records of pa-tients with sepsis at the Sun Yat-sen Memorial Hospital from March 2018 to October 2022.Univariate and multivariate Lo-gistic regression were performed to identify the independent risk factors of ARDS,and then a joint prediction model was constructed based on the results of multivariate regression analysis.Results:A total of 303 patients were en-rolled in this study which including 145 patients with ARDS and 158 patients without ARDS.There was statistical signifi-cance between the two groups of patients(P<0.05)in terms of oxygenation index,blood oxygen,urea nitrogen,dia-stolic blood pressure,albumin,SOFA score,septic shock,pulmonary and urinary tract infections.Multivariate logis-tic regression analysis showed that albumin,oxygenation index,diastolic blood pressure,septic shock and pulmonary in-fection were independent predictors for the occurrence of septic ARDS.The area under the curve of the ARDS joint predic-tion model is 0.812(95%CI 0.76-0.86),the sensitivity is 69.7%,and the specificity is 84%.Conclusion:The ARDS prediction model constructed by combining indicators has good predictive performance,which is helpful for the clinical diagnosis and treatment of patients.

关 键 词：急性呼吸窘迫综合征 脓毒症 危险因素 预测模型 血清学指标 

分 类 号：R459.7[医药卫生—急诊医学] R563.8[医药卫生—治疗学]