摘要
目的探讨血清可溶性抑瘤因子-2、白介素-8水平在预测急性呼吸窘迫综合征机械通气患者拔管结局的价值。方法选择2017年1月1日-2019年12月31日某院收治的75例已经通过2h自主呼吸试验拟拔管的ARDS患者,其中拔管成功63例作为成功组,拔管失败12例作为失败组。收集临床资料,检测血清sST2、IL-8水平,分析sST2、IL-8与急性肺损伤评分、ARDS机械通气患者拔管失败的关系以及sST2、IL-8对拔管失败的预测价值。结果ARDS机械通气患者拔管成功组血清sST2、IL-8水平低于失败组(P<0.05),Spearman秩相关性分析结果示血清sST2、IL-8水平与急性肺损伤评分均呈正相关(rs=0.513、0.547,P<0.05),二元Logistic回归结果显示机械通气时间延长(OR=2.010,95%CI:1.952~2.136)、高急性肺损伤评分(OR=1.738,95%CI:1.653~1.754)、高水平sST2(OR=1.614,95%CI:1.534~1.840)、高水平IL-8(OR=1.527,95%CI:1.425~1.687)是ARDS机械通气患者拔管失败的危险因素(P<0.001)。ROC分析结果显示sST2、IL-8、联合sST2+IL-8预测ARDS机械通气患者拔管失败的曲线下面积(AUC)分别为0.870、0.751、0.992,SE分别为75.00%、66.67%、91.67%,SP分别为82.54%、84.13%、95.24%。结论sST2、IL-8水平增高与ARDS机械通气患者拔管失败密切相关,可作为预测拔管结局的参考指标。
Objectives To investigate the value of serum levels of soluble tumor suppressor factor-2 and interleukin-8 in predicting extubation outcome of mechanical ventilation patients with acute respiratory distress syndrome.Methods From January 1 st,2017 to December 31 st,2019,75 patients with ARDS who had passed the 2 h spontaneous breathing test were selected.Among them,63 patients with successful extubation were considered as the successful group,and 12 patients with failed extubation were considered as the failure group.Clinical data were collected and serum levels of SST2 and IL-8 were detected to analyze the relationship between SST2 and IL-8 and acute lung injury score,extubation failure in patients with ARDS mechanical ventilation,and the predictive value of SST2 and IL-8 in extubation failure.Results ARDS patients with mechanical ventilation tube drawing successful group of serum sST2,IL-8 level below the failure group(P<0.05),Spearman rank correlation analysis results in serum sST2,IL-8 levels,there was a positive correlation with acute lung injury score(rs=0.513,0.547,P<0.05),the binary Logistic regression results showed prolonged mechanical ventilation(OR=2.010,95%CI:1.952~2.136),high acute lung injury score(OR=1.738,95%CI:1.653~1.754),high level of SST2(OR=1.614,95%CI:1.534~1.840)and high level of IL-8(OR=1.527,95%CI:1.425~1.687)were risk factors for extubation failure in patients with ARDS mechanical ventilation(P<0.001).ROC analysis showed that the area under the curve(AUC)of SST2,IL-8,combined with SST2+IL-8 for predicting extubation failure in patients with ARDS mechanical ventilation was 0.870,0.751,0.992,SE was 75.00%,66.67%,91.67%,and SP was 82.54%,84.13%,95.24%,respectively.Conclusions The increased levels of SST2 and IL-8 were closely related to the failure of extubation in patients with ARDS mechanical ventilation,which could be used as a reference index to predict the outcome of extubation.
作者
陈谦
蒋文强
Chen Qian;Jiang Wenqiang(Department of Emergency,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China;不详)
出处
《中国病案》
2021年第5期99-103,共5页
Chinese Medical Record
关键词
急性呼吸窘迫综合征
可溶性抑瘤因子-2
白介素-8
机械通气
拔管
Acute respiratory distress syndrome
Soluble tumor suppressor factor-2
Interleukin-8
Mechanical ventilation
Extubation
