摘要
目的探讨红细胞分布宽度(RDW)联合胸部创伤严重性(TTS)评分对肺挫伤致急性呼吸窘迫综合征(ARDS)的预测价值。方法选择2022年2月—2023年2月于本院重症医学科符合纳入标准患者的临床资料,包括患者的一般资料、白细胞计数(WBC)、RDW、C反应蛋白、血气分析、氧合指数、肝肾功能、胸部CT、创伤原因、既往病史、并发症、TTS评分。根据柏林标准分为ARDS组和非ARDS组,分析两组的一般临床资料,绘制RDW、TTS评分及RDW联合TTS评分的ROC曲线。结果符合纳入标准的患者有56例,其中男性39例,女性17例。发生ARDS的有25例,31例未发生ARDS。其中发生机制为车祸伤42例,堕落伤5例,爆裂伤4例,重物砸伤2例,其他原因外伤3例。两组发生肺挫伤的患者中男性均多于女性,肺挫伤中创伤原因为车祸的人数最多。TTS评分、RDW、WBC、氧合指数(PaO2/FiO2)比较差异有统计学意义(P<0.05),RDW与WBC、TTS、RDW/ALB呈正相关(r=0.186,P=0.05;r=0.648,P=0.001;r=0.812,P=0.003),与PaO2/FiO2呈负相关(r=-0.013,P=0.006)。RDW、TTS、RDW联合TTS评分的曲线下面积(AUC)分别为0.811、0.966、0.976,RDW联合TTS评分的AUC高于RDW及TTS评分单独预测。结论RDW、TTS、RDW联合TTS评分对肺挫伤致ARDS均有较好的预测效能,但RDW联合TTS评分评估肺挫伤致ARDS发生的特异性及敏感性优于单个临床指标。
Objective To explore the predictive value of red blood cell distribution width(RDW)combined with thoracic trauma severity(TTS)score for pulmonary contusion-induced acute respiratory distress syndrome(ARDS).Methods Select clinical data of patients who meet the inclusion criteria in the intensive care department of our hospital from February 2022 to February 2023,including general information,white blood cell count(WBC),RDW,C-reactive protein,blood gas analysis,oxygenation index,liver and kidney function,chest CT,cause of trauma,past medical history,complications,and TTS score.Divide into ARDS group and non ARDS group according to the Berlin criteria,analyze the general clinical data of the two groups,and plot the ROC curves of RDW,TTS scores,and RDW combined with TTS scores.Results There were 56 patients who met the inclusion criteria,including 39 males and 17 females.25 cases experienced ARDS,while 31 cases did not.The mechanism of occurrence was that 42 cases were injured in car accidents,5 cases were injured in falls,4 cases were injured in explosions,2 cases were injured in heavy objects,and 3 cases were injured from other reasons.Both groups of patients with lung contusions had more males than females,with the highest number of injuries caused by car accidents.There was a statistically significant difference in TTS score,RDW,WBC,and PaO2/FiO2 comparison(P<0.05),RDW were positively correlated with WBC,TTS,RDW/ALB(r=0.186,P=0.05;r=0.648,P=0.001;r=0.812,P=0.003),and negatively correlated with PaO2/FiO2(r=-0.013,P=0.006).The AUCs of RDW,TTS,and RDW combined with TTS scores were 0.811,0.966,and 0.976,and the AUC of RDW combined with TTS scores was higher than that of RDW and TTS scores.Conclusion RDW,TTS,and RDW combined with TTS score all have strong predictive value for ARDS.The specificity and sensitivity of RDW combined with TTS score in evaluating the occurrence of ARDS after pulmonary contusion are better than single clinical indicators.
作者
丁珏婧
张晓娇
林倩
DING Juejing;ZHANG Xiaojiao;LIN Qian(Department of Critical Care Medicine,North Hospital of Hebei University Affiliated Hospital,Baoding Hebei 071000,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第5期624-627,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
2022年河北省卫生健康委员会科研项目(编号:20220967)。
关键词
肺挫伤
急性呼吸窘迫综合征
红细胞分布宽度
胸部创伤严重评分
Pulmonary contusion
Acute respiratory distress syndrome
Red blood cell distribution width
Chest trauma severity score
