摘要
目的探讨肺损伤预测评分(LIPS)联合生物学标志物对脓毒症并发急性呼吸窘迫综合征(ARDS)的预测价值。方法回顾性分析2019年1月7日至2022年3月25日天津市天津医院重症监护室收治的223例脓毒症患者的临床资料,根据是否出现ARDS分为非ARDS组(148例)及ARDS组(75例)。比较两组患者的临床资料,通过单因素和多因素logistic回归分析脓毒症并发ARDS的危险因素,绘制受试者工作特征(ROC)曲线,评估LIPS联合生物学标志物对脓毒症并发ARDS的预测价值。结果单因素分析显示,ARDS组D-二聚体、乳酸、脑钠肽和LIPS高于非ARDS组,氧合指数(OI)、白蛋白低于非ARDS组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,D-二聚体(OR 1.002,95%CI 1.000~1.003,P=0.018),LIPS(OR 1.590,95%CI 1.345~1.881,P<0.001)为脓毒症并发ARDS的独立危险因素,OI(OR 0.971,95%CI 0.957~0.985,P<0.001)是脓毒症并发ARDS的独立保护因素。绘制ROC曲线,LIPS评分曲线下面积为0.828,最佳截断值为5.00,灵敏度及特异度分别为78.21%和69.23%;LIPS评分联合D-二聚体、OI,ROC曲线下面积为0.900,灵敏度及特异度分别为87.18%和79.49%。结论LIPS评分联合生物学标志物对脓毒症并发ARDS具有较好的预测价值。
Objective To explore the predictive value of lung injury prediction score(LIPS)combined with biomarkers in sepsis complicated with acute respiratory distress syndrome(ARDS).Methods Clinical data of 223 patients with sepsis admitted to the Intensive Care Unit of Tianjin Hospital from January 7,2019 to March 25,2022 were retrospectively analyzed,and they were divided into non-ARDS group(148 cases)and ARDS group(75 cases)according to whether ARDS occurred.The clinical data of the two groups were compared,the risk factors of sepsis complicated with ARDS were analyzed by univariate and multivariate logistic regression,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of LIPS combined with biomarkers in sepsis complicated with ARDS.Results Univariate analysis showed that D-dimer,lactic acid,BNP and LIPS in ARDS group were higher than those in non-ARDS group,OI and ALB were lower than those in non-ARDS group,and the difference was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that D-D(OR 1.002,95%CI 1.000-1.003,P=0.018),LIPS(OR 1.590,95%CI 1.345-1.881,P<0.001)were independent risk factors for ARDS in sepsis,and OI(OR 0.971,95%CI0.957-0.985,P<0.001)was the indepedent protective factor for ARDS in sepsis.ROC curve was drawn,the area under the LIPS score curve was 0.828,the optimal cut-off value was 5.00,and the sensitivity and specificity were 78.21%and69.23%,respectively.LIPS score combined with D-dimer and OI showed that the area under ROC curve was 0.900,and the sensitivity and specificity were 87.18%and 79.49%,respectively.Conclusion LIPS score combined with biomarkers has good predictive value for sepsis complicated with ARDS.
作者
赵春玲
袁红岩
尤丕聪
刘美蓉
王秋义
ZHAO Chun-ling;YUAN Hong-yan;YOU Pi-cong;LIU Mei-rong;WANG Qiu-yi(Intensive Care Unit,Tianjin Hospital,Tianjin 300210,China)
出处
《中国实用内科杂志》
CSCD
北大核心
2023年第9期740-743,共4页
Chinese Journal of Practical Internal Medicine
基金
天津市卫生健康委员会天津市中医药管理局中医中西医结合科研课题(2021158)。
作者简介
通信作者:刘美蓉,电子信箱:liumeironghot@163.com。
