摘要
目的:探讨舌下微循环灌注血管比例变化率(ΔPPV)联合血清多配体蛋白聚糖-1(SDC-1)水平对脓毒症休克并急性呼吸窘迫综合征(ARDS)预后的预测价值。方法:选取2021年10月至2023年1月入住本院呼吸重症监护病房的脓毒症休克并ARDS患者,采集确诊后0、6、24和72 h的外周血,检测SDC-1、乳酸(Lac)等实验室指标,并收集相同时间点的舌下微循环图像,计算得到ΔPPV、乳酸清除率(LCR);分别于0、24 h和72 h行序贯器官衰竭(SOFA)评分。根据28 d生存情况分为生存组和死亡组。选取2组间单因素分析有意义的变量及72 hΔPPV联合SDC-1绘制ROC曲线,分析上述指标预测脓毒症休克并ARDS患者28 d内死亡的价值。结果:ROC分析结果显示,24 h SDC-1、LCR,72 h SOFA评分、ΔPPV、SDC-1及72 hΔPPV联合SDC-1对预后有预测价值(P均<0.05),其中72 hΔPPV联合SDC-1曲线下面积最大[AUC(95%CI)为0.832(0.721~0.943)],敏感度为0.931,特异度为0.680。结论:72 hΔPPV联合SDC-1比单一指标对脓毒症休克并ARDS预后具有更高的预测价值。
Aim:To investigate the prognosis predictive value of sublingual microcirculation proportion of perfusion vessel change rate(ΔPPV)combined with serum syndecan-1(SDC-1)in patients with septic shock and acute respiratory distress syndrome(ARDS).Methods:The peripheral blood of patients with septic shock and ARDS admitted to the Respiratory Intensive Care Unit of our hospital from October 2021 to January 2023 were collected for testing SDC-1,lactate,and other laboratory indicators in the first 3 days(0,6,24 and 72 hours),sublingual microcirculation images were collected at the same time,andΔPPV and lactate clearance rate(LCR)were calculated.Sequential organ failure(SOFA)scores were assessed within the first 3 days(0,24,and 72 hours),respectively.The patients were allocated into 2 groups according to their survival status within 28 days.The different indicators between the 2 groups and 72 hourΔPPV+SDC-1 were chosen,and the receiver operating characteristic curve(ROC)was used to analyze the predictive value of the above indicators for death within 28 days in patients with septic shock and ARDS.Results:ROC analysis showed that 24 hour SDC-1,24 hour LCR,72 hour SOFA score,72 hourΔPPV,72 hour SDC-1,and 72 hourΔPPV+SDC-1 had predictive value for prognosis(all P<0.05);among them,the area under the curve(AUC)of 72 hourΔPPV combined with SDC-1 was the largest[AUC(95%CI)=0.832(0.721-0.943)],with sensitivity of 0.931 and specificity of 0.680.Conclusion:72 hourΔPPV combined with SDC-1 have a higher predictive value than single indicator for the prognosis of patients with septic shock and ARDS.
作者
黄淑雅
李双凤
张磊
董睿
张瑞霞
高延秋
HUANG Shuya;LI Shuangfeng;ZHANG Lei;DONG Rui;ZHANG Ruixia;GAO Yanqiu(Respiratory Intensive Care Unit,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450002)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2024年第2期163-167,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省科技攻关项目(182102310177)
河南省医学科技攻关计划联合共建项目(LHGJ20210778,LHGJ20200772)
河南省高等学校重点科研项目(23A320036)。
