血清TIPE2联合LIPS、APACHEⅡ评分对脓毒症并发急性呼吸窘迫综合征的预测价值  

Predictive value of serum TIPE2 combined with LIPS and APACHEⅡscores on sepsis complicated with acute respiratory distress syndrome

作　　者：刘倩 吕雨珍 吴倩佳 LIU Qian;LYU Yuzhen;WU Qianjia(Department of Respiratory and Critical Care Medicine,Yangquan Coal Industry(Group)General Hospital,Yangquan 045000,China)

机构地区：[1]阳泉煤业(集团)有限责任公司总医院呼吸及危重症医学科,045000

出　　处：《浙江医学》2024年第21期2283-2287,共5页Zhejiang Medical Journal

摘　　要：目的探讨血TNF-α诱导蛋白8样因子2(TIPE2)联合肺损伤预测评分(LIPS)、急性生理学和慢性健康状况评价(APACHE)Ⅱ评分对脓毒症并发急性呼吸窘迫综合征(ARDS)的预测价值。方法回顾性选取2019年6月至2023年6月在阳泉煤业(集团)有限责任公司总医院诊断为脓毒症的164例患者为研究对象,住院期间并发ARDS 62例(ARDS组),未并发ARDS 102例(非ARDS组)。比较脓毒症是否并发ARDS患者临床资料,采用多因素logistic回归分析脓毒症并发ARDS的影响因素,采用ROC曲线分析血清TIPE2、LIPS和APACHEⅡ评分单独及联合预测脓毒症并发ARDS的效能。结果脓毒症是否并发ARDS患者在血清白蛋白、CRP、PCT、TIPE2水平及LIPS、APACHEⅡ评分等方面比较,差异均有统计学意义(均P<0.01)。高血清TIPE2水平(OR=0.718)是脓毒症并发ARDS的独立保护因素,高LIPS(OR=4.937)、高APACHEⅡ评分(OR=1.944)是脓毒症并发ARDS的独立危险因素,差异均有统计学意义(均P<0.05)。血清TIPE2、LIPS和APACHEⅡ评分单独及联合预测脓毒症并发ARDS的AUC分别为0.851、0.664、0.883和0.980,灵敏度分别为0.814、0.539、0.804和0.931,特异度分别为0.936、0.839、0.839和0.936。结论血清TIPE2水平降低以及LIPS和APACHEⅡ评分升高与脓毒症并发ARDS有关,3项联合有助于提高对脓毒症并发ARDS的预测效能。Objective To investigate the predictive value of serum tumor necrosis factorαinduced protein 8 like 2(TIPE2)combined with Lung Injury Prediction Score(LIPS),and Acute Physiology And Chronic Health EvaluationⅡ(APACHEⅡ)score on sepsis patients complicated with acute respiratory distress syndrome(ARDS).Methods A retrospective study was conducted on 164 patients diagnosed as sepsis in Yangquan Coal Industry(Group)General Hospital from June 2019 to June 2023.According to whether ARDS occurred during hospitalization,they were divided into ARDS group(n=62)and non ARDS group(n=102).The difference of clinical data between the two groups was compared.The influencing factors for sepsis complicated with ARDS were analyzed by multivariate logistic regression,and the predictive performances of serum TIPE2,LIPS and APACHEⅡscores alone and in combination were analyzed by ROC curve for the occurrence of ARDS in sepsis patients.Results Serum TIPE2,and albumin levels of ARDS group were lower than those of non-ARDS group;while C-reactive protein,procalcitonin levels,LIPS score and APACHEⅡscore were higher than those of non-ARDS group(all P<0.05).High serum TIPE2 level was an independent protective factor for sepsis complicated with ARDS(OR=0.718),while high LIPS score(OR=4.937)and high APACHEⅡscore(OR=1.944)were independent risk factors(all P<0.05).The AUCs of serum TIPE2,LIPS score,and APACHEⅡscore alone and in combination in predicting sepsis complicated with ARDS were 0.851,0.664,0.883 and 0.980,respectively,while the sensitivity and specificity were 0.814,0.539,0.804 and 0.931;and 0.936,0.839,0.839 and 0.936,respectively.Conclusion The decrease of serum TIPE2 level and increased LIPS and APACHEⅡscores are associated with ARDS in patients with sepsis.The combination of the three indicators has certain predictive value for sepsis complicated with ARDS.

关 键 词：脓毒症 急性呼吸窘迫综合征 肿瘤坏死因子-α诱导蛋白8样因子2 预测效能 

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