摘要
目的探讨老年呼吸衰竭合并脓毒性休克患者血管外肺水指数(EVLWI)的特点及其对死亡的预测价值。方法 36例老年呼吸衰竭合并脓毒性休克患者,按其临床结局分为存活组21例和死亡组15例,采用PICCO plus检测仪监测两组患者EVLWI、全心射血分数(GEF)、系统血管阻力(SVRI)、中心静脉压(CVP)、心指数(CI)、心率(HR)、平均动脉压(MAP)并监测APACHEⅡ评分及血乳酸。结果死亡组APACHEⅡ评分、血乳酸水平、EVLWI高于存活组(P均<0.05),两组CI、GEF、SVRI、CVP、HR及MAP比较,差异均无统计学意义(P均>0.05)。描绘EVLWI的ROC曲线发现以EVLWI≥10 ml/kg为界点,预测死亡发生的灵敏度为66.67%,特异度为90.48%,阳性预测值83.33%,阴性预测值79.17%。结论老年呼吸衰竭合并脓毒性休克患者EVLWI明显增高者死亡率高,以EVLWI≥10 ml/kg为界点可作为判断预后不良的指标。
Objective To investigate the characteristics and prognostic value of extravascular lung water index （ EVLWI ） for the death in elderly patients with respiratory failure and septic shock .Methods Thirty-six elderly patients with respiratory failure and septic shock were divided into survival group （ 21 patients ） and death group （ 15 patients） according to clinical outcome .All the patients were monitored with pulse indicator continuous cardiac output （PICCO） monitor,and their EVLWI,general ejection fraction （GEF）,system vascular resistance index （SVRI）,central venous pressure （ CVP ） , cardiac index （ CI ） , heart rate （ HR ） and mean arterial pressure （ MAP ） were collected;The APACHEⅡscore and blood lactate（Lac） and were also recorded .Results APACHEⅡscore,Lac,EVLWI in the death group were significantly higher than those in the survival group （P〈0.05）,CI,GEF,SVRI,CVP,HR and MAP showed no significant difference between two groups （ all P〉0 .05 ） .The ROC curve of EVLWI indicated that EVLWI≥10 ml/kg could be the value of prognosis for death ,and the sensitivity,specificity,positive predictive value,negative predictive value were 66.67%,90.48%,83.33%,79.17% respectively.Conclusion The mortality of elderly patients with respiratory failure and septic shock increases while EVLWI is significantly higher ,EVLWI≥10 ml/kg can be the value of prognosis for death .
出处
《广西医学》
CAS
2014年第1期44-46,共3页
Guangxi Medical Journal
基金
广西医药卫生科研课题(Z203356)
关键词
呼吸衰竭
脓毒性休克
血管外肺水指数
老年人
Respiratory failure
Septic shock
Extravascular lung water index
Elderly
作者简介
E-mail：26993979@qq．com.向淑麟（1981-），女，硕士研究生，主治医师，研究方向：重症医学。
