摘要
目的:探讨血管外肺水指数(ELWI)联合血浆脑钠肽(BNP)水平对脱机相关肺水肿的诊断价值。方法:选取2013年6月至2015年5月于我院ICU进行通气治疗的患者80例为研究对象,采用PICCO监测患者治疗前后的ELWI并采用ELISA法检测同期血浆BNP水平,对脱机时出现呼吸困难症状患者进行床边摄胸片检查确诊脱机相关肺水肿的发生情况,根据患者脱机相关肺水肿发生情况分为并发组(n=30)和非并发组(n=50)。比较并发组和非并发组治疗前后的ELWI和血浆BNP水平,采用Spearman相关分析法分析ELWI和血浆BNP水平与脱机相关肺水肿发生率的关系,采用受试者操作特性曲线(ROC)分析ELWI和血浆BNP水平联合诊断脱机相关肺水肿的价值。结果:与非并发组比较,并发组治疗3、7和10 d的ELWI和血浆BNP水平均升高,差异有统计学意义(P<0.05)。Spearman相关分析结果显示,ELWI和血浆BNP水平与脱机相关肺水肿发生率均呈正相关(r=0.852、0.846,P<0.05)。ROC曲线分析结果显示,ELWI和血浆BNP水平联合诊断脱机相关肺水肿的临界值为19.28 ml·kg-1和635.72 pg·ml-1,曲线下面积为0.826,敏感度、特异度、准确性、阳性预测值和阴性预测值分别为95.00%、99.07%、97.97%、97.44%和98.17%,ELWI和血浆BNP水平联合诊断脱机相关肺水肿的价值良好。结论:脱机相关肺水肿患者的ELWI和血浆BNP水平联合诊断脱机相关肺水肿的价值良好,可能作为脱机相关肺水肿辅助诊断的参考指标。
Objective： To investigate the value of extravascular lung water index（ ELWI） combined with plasma brain natriuretic peptide（ BNP） levels in diagnosing weaning-induced pulmonary edema. Methods： 80 cases of patients had ventilation treatment in ICU of our hospital from June 2013 to May 2015 were selected as the research object. PICCO monitor was applied in detecting ELWI of the patients before and after treatment and ELISA method was applied to detect plasma BNP levels in the same period. The patients with dyspnea symptoms when offline had digital radiography（ DR） exam to diagnose weaning-induced pulmonary edema. The patients were divided into concurrent group（ n = 30） and non concurrent group（ n = 50） according to the occurrence of weaning-induced pulmonary edema. ELWI and plasma BNP level of concurrent group and non concurrent group before and after treatment were compared. Spearman correlation analysis was used to analyze relationship between the ELWI and plasma BNP levels with the weaning- induced pulmonary edema incidence,and operating characteristic curve（ ROC） was applied in analysing the value of ELWI and plasma BNP level jointly diagnosing of weaning-induced pulmonary edema. Results： Compared with the non concurrent group,ELWI and plasma BNP levels of concurrent groups after treatment 3,7 and 10 d were higher,and the difference was statistically significant（ P〈0. 05）.Spearman correlation analysis results showed that ELWI and plasma BNP levels were positively correlated with weaning-induced pulmonary edema incidence（ r = 0. 852,0. 846,P〈0. 05）. ROC curve analysis results showed that the cut off value of ELWI and plasma BNP level jointly diagnosing weaning-induced pulmonary edema was19. 28 ml · kg^-1 and 635. 72 pg · ml^-1,the area under the curve was 0. 826,and the sensitivity,specific,accuracy,positive predictive value and negative predictive value were 95. 00%,99. 07%,97. 97%,97. 44% and98. 17%,respectively. The value of ELWI and plasma BNP level jointly diagnos
出处
《现代医学》
2016年第5期666-670,共5页
Modern Medical Journal
关键词
血管外肺水指数
脑钠肽
脱机相关肺水肿
诊断
extravascular lung water index
brain natriuretic peptide
weaning-induced pulmonary edema
diagnosis
