摘要
目的探讨肺间质纤维化急性加重期患者动脉血气指标对预后死亡的预测价值,以期及时应对肺间质纤维化预后死亡。方法选择2018年12月—2019年12月于成都市第二人民医院处于急性加重期的肺间质纤维化患者132例为研究对象。随访时间20个月,均行醋酸泼尼松联合盐酸氨溴索的药物治疗,按照治疗效果,分为死亡组(n=25)和生存组(n=107)。记录患者临床资料及症状,并测定患者生化指标。结果两组患者临床情况比较发现,死亡组患者在吸烟史、呼吸机通气时间≥4 d的发生率多于生存组,且差异比较有统计学意义(P<0.05);两组患者在症状为干咳、呼吸困难、胸痛方面比较,死亡组发生率高于生存组,死亡组指脉氧低于生存组,且以上各指标比较差异有统计学意义(P<0.05);实验室检查指标比较,死亡组HGB、LYM、RI、SaO_(2)、PO_(2)水平低于生存组;多因素Logistic回归分析显示,HGB≤118.52 g/L、WBC≥7.14×10^(9)/L、LYM≤0.67×10^(9)/L、MONO≥0.48×10^(9)/L、CRP≥78.52 mg/L、PCT≥1.15μg/L、RI≤0.31、PCO_(2)≥51.03 mmHg、SaO_(2)≤82.11%、PO_(2)≤59.29 mmHg是预后死亡的独立危险因素,XGboost模型和多因素Logistic回归分析模型的预测效能一致性良好。结论RI、SaO_(2)、PCO_(2)、PO_(2)等动脉血气指标均可作为单独预测肺间质纤维化急性加重期患者预后死亡的临床指标,且联合血常规等指标进行分析,预测效果更佳。
Objective To explore the predictive value of arterial blood gas indicators for prognostic death in patients with acute exacerbation of pulmonary interstitial fibrosis,in order to respond to the prognostic death of pulmonary fibrosis in time.Methods 132 patients with pulmonary interstitial fibrosis who were in the acute exacerbation period in Chengdu Second People's Hospital from December 2018 to December 2019 were selected as the research objects.Follow-up time was 20 months,all patients were treated with prednisone acetate combined with ambroxol hydrochloride.According to the treatment effect,they were divided into death group(n=25)and survival group(n=107).Record the patient's clinical data and symptoms,and determine the patient's biochemical indicators.Results Comparing the clinical conditions of the two groups of patients,it was found that the incidence of smoking history and ventilator ventilation time≥4 d in the death group was higher than that in the survival group,and the difference was statistically significant(P<0.05);the two groups of patients had a symptom comparison.Compared with the symptoms of dry cough,dyspnea and chest pain,the incidence of death in the death group was higher than that in the survival group,and the finger pulse oxygen in the death group was lower than that in the survival group.There was a statistically significant difference in the above indicators(P<0.05);Comparing laboratory indicators,the levels of HGB,LYM,RI,SaO_(2),and PO_(2) in the death group were lower than those in the survival group;multivariate logistic regression analysis showed that HGB≤118.52 g/L,WBC≥7.14×10^(9)/L,LYM≤0.67×10^(9)/L,MONO≥0.48×10^(9)/L,CRP≥78.52 mg/L,PCT≥1.15μg/L,RI≤0.31,PCO_(2)≥51.03 mmHg,SaO_(2)≤82.11%,PO_(2)≤59.29 mmHg are independent prognostic deaths Risk factors,XGboost model and multivariate logistic regression analysis model have good consistency in evaluating the predictive power.Conclusion Arterial blood gas indicators such as RI,SaO_(2),PCO_(2),and PO_(2) can be used as independent clinical indicators for predicting the prognosis and death of patients with acute exacerbation of pulmonary interstitial fibrosis,and combined with blood routine and other indicators for analysis,the prediction effect is better.
作者
甘庆
刘权
唐勇
GAN Qing;LIU Quan;TANG Yong(Emergency Department,Chengdu Second People's Hospital,Chengdu Sichuan 610000,Chin)
出处
《中国急救复苏与灾害医学杂志》
2022年第11期1446-1449,1510,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川省卫生和计划生育委员会科研课题(编号:16PJ033)。
关键词
肺间质纤维化
急性加重期
动脉血气指标
预后死亡
预测价值
Pulmonary interstitial fibrosis
Acute exacerbation period
Arterial blood gas index
Prognostic death
作者简介
通信作者:甘庆,E-mail:gan1350566863@163.com。
