• 血浆和肽素水平联合氧合指数及肺血管通透性指数可预测急性呼吸窘迫综合征患者的预后
  • Plasma copeptin level combined with oxygenation index and pulmonary vascular permeability index may predict the prognosis of patients with acute respiratory distress syndrome
  • 黎秋香.血浆和肽素水平联合氧合指数及肺血管通透性指数可预测急性呼吸窘迫综合征患者的预后[J].内科急危重症杂志,2021,27(5):405-408
    DOI:10.11768/nkjwzzzz20210512
    中文关键词:  急性呼吸窘迫综合征  和肽素  氧合指数  肺血管通透性指数  预后
    英文关键词:
    基金项目:
    作者单位E-mail
    黎秋香 海南西部中心医院呼吸内科 l18876649612@163.com 
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    中文摘要:
          目的: 探讨血浆和肽素(Copeptin)联合氧合指数(OI)及肺血管通透性指数(PVPI)预测急性呼吸窘迫综合征(ARDS)患者预后的价值。方法: 选择2017年1月至2019年12月海南西部中心医院呼吸内科收治的112例ARDS患者,收集患者的性别、年龄、体重指数、基础疾病、病因、心率、呼吸频率、动脉血氧分压、动脉血二氧化碳分压、呼气末正压及OI等基线值。根据ARDS患者住院28 d生存情况分为存活组和死亡组;根据ARDS患者OI分为轻度组(200 mmHg<OI≤300 mmHg)、中度组(l00 mmHg<OI≤200 mmHg)和重度组(OI≤l00 mmHg)。采用酶联免疫吸附法检测患者血浆Copeptin水平,并测定OI及PVPI。绘制受试者工作特征(ROC)曲线分析血浆Copeptin水平联合OI及PVPI预测ARDS患者死亡的价值;采用Pearson相关法分析ARDS患者血浆Copeptin水平与OI及PVPI的相关性。结果:死亡组患者血浆Copeptin水平及PVPI明显高于存活组,OI明显低于存活组,差异有统计学意义(P均<0.001)。随着ARDS患者病情加重,血浆Copeptin水平及PVPI升高,而OI减低(P均<0.001)。ROC曲线分析显示,血浆Copeptin水平联合OI及PVPI预测ARDS患者死亡的曲线下面积(AUC)明显高于三者单独预测(AUC:0.896 vs 0.824、0.780、0.797),其敏感度和特异度均较高,分别为90.5%、83.7%。相关分析显示,ARDS死亡患者血浆Copeptin水平与OI呈负相关(r=-0.603,P<0.001),与PVPI呈正相关(r=0.662,P<0.001)。结论:血浆Copeptin水平、OI及PVPI与ARDS患者病情严重程度及预后有关,三者联合检测对预测ARDS患者的预后有重要意义。
    英文摘要:
          Objective: To explore the prognostic value of plasma peptide level combined with oxygenation index (OI) and pulmonary vascular permeability index (PVPI) in patients with acute respiratory distress syndrome (ARDS). Methods: Totally, 120 patients with ARDS admitted to Department of Respiratory Diseases, Hainan West Central Hospital from January 2017 to December 2019 were selected. The baseline values of sex, age, body mass index, basic diseases, etiology, heart rate, respiratory rate, arterial oxygen partial pressure, arterial carbon dioxide partial pressure, positive end expiratory pressure and oxygenation index (OI) were collected. According to the 28-day survival, ARDS patients were divided into survival group and death group. According to OI, the ARDS patients were divided into mild group (200 mmHg