血清乳酸、LIPS评分联合FIB/ALB对重型颅脑损伤患者并发急性呼吸窘迫综合征的评估价值  

Evaluation Value of Serum Lactic Acid,LIPS Score Combined with FIB/ALB in Patients with Severe Traumatic Brain Injury Complicated with Acute Respiratory Distress Syndrome

作　　者：陈涛 郑锦亮 官测林 苏鑫洪 曹志红 祁小龙 刘天庆 CHEN Tao;ZHENG Jin-liang;GUAN Ce-lin;SU Xin-hong;CAO Zhi-hong;QI Xiao-long;LIU Tian-qing-(Department of Neurosurgery,Longyan First Hospital Affiliated to Fujian Medical University,Longyan,Fujian,364000,China)

机构地区：[1]福建医科大学附属龙岩第一医院神经外科,福建龙岩364000

出　　处：《现代生物医学进展》2025年第6期1039-1048,共10页Progress in Modern Biomedicine

摘　　要：目的:探讨血清乳酸(Lac)、肺损伤预测评分(LIPS)联合纤维蛋白原/白蛋白(FIB/ALB)对重型颅脑损伤(s TBI)患者并发急性呼吸窘迫综合征(ARDS)的评估价值。方法:选取2022年1月至2024年3月我院收治的s TBI患者179例,根据是否并发ARDS分为ARDS组(60例)和非ARDS组(119例),检测血清Lac和计算LIPS评分、FIB/ALB。多因素非条件Logistic回归分析确定其影响因素,绘制受试者工作特征(ROC)曲线分析血清Lac、LIPS评分联合FIB/ALB对s TBI患者并发ARDS的预测能效。结果:179例s TBI患者ARDS并发率为33.52%(60/179)。ARDS组血清Lac水平、LIPS评分和FIB/ALB均高于非ARDS组(P均<0.05)。与非ARDS组比较,ARDS组弥漫性轴索损伤、肺挫伤、多发性肋骨骨折比例和FIB水平升高,ALB水平降低(P<0.05)。s TBI患者并发ARDS的独立危险因素为弥漫性轴索损伤、肺挫伤、多发性肋骨骨折、Lac、LIPS评分和FIB/ALB(P均<0.05)。血清Lac、LIPS评分联合FIB/ALB预测s TBI患者并发ARDS的曲线下面积(AUC)为0.929,大于血清Lac、LIPS评分、FIB/ALB单独预测的0.781、0.832、0.809。结论:血清Lac、LIPS评分和FIB/ALB均为s TBI患者并发ARDS的独立危险因素,三者联合检测对s TBI患者并发ARDS的预测效能较高。Objective:To investigate the evaluation value of serum lactic acid(Lac),lung injury predic tion score(LIPS)combined with fibrinogen/albumin(FIB/ALB)in patients with severe traumatic brain injury(s TBI)complicated with acute respiratory distress syndrome(ARDS).Methods:179 patients with s TBI who were admitted to our hospital from January 2022 to March 2024 were selected,and patients were divided into ARDS group(60 cases)and non ARDS group(119 cases)according to whether they were complicated with ARDS,serum Lac was detected and LIPS score and FIB/ALB were calculated.The influencing factors of patients with s TBI complicated with ARDS were determined by multivariate unconditional Logistic regression analysis,the predictive energy efficiency of serum Lac,LIPS score combined with FIB/ALB for patients with s TBI complicated with ARDS was analyzed by drawn receiver operating characteristic(ROC)curve.Results:The incidence of ARDS in 179 patients with s TBI was 33.52%(60/179).The serum Lac level,LIPS score and FIB/ALB in ARDS group were higher than those in non ARDS group(all P<0.05).Compared with non ARDS group,the proportion of diffuse axonal injury,pulmonary contusion,multiple rib fractures and FIB level in ARDS group were increased,and ALB level was decreased(P<0.05).The independent risk factors for patients with s TBI complicated with ARDS were diffuse axonal injury,pulmonary contusion,multiple rib fractures,Lac,LIPS score and FIB/ALB(all P<0.05).The area under the curve(AUC)of serum Lac,LIPS score combined with FIB/ALB in predicting patients with s TBI complicated with ARDS was 0.929,which was greater than 0.781,0.832 and 0.809 predicted by serum Lac,LIPS score and FIB/ALB alone.Conclusion:Serum Lac,LIPS score and FIB/ALB are all independent risk factors for patients with s TBI complicated with ARDS,and the combined detection of the three has a higher predictive efficiency for patients with s TBI complicated with ARDS.

关 键 词：重型颅脑损伤 急性呼吸窘迫综合征 乳酸 肺损伤预测评分 纤维蛋白原/白蛋白 

分 类 号：R3[医药卫生—基础医学] R651.15R563.8