摘要
目的:分析中心静脉-动脉血二氧化碳分压差/动脉-中心静脉血氧含量差[P(cv-a)CO_(2)/C(a-cv)O_(2)]与脓毒症发生病情恶化风险的相关性。方法:将脓毒症病人169例根据治疗后的病情转归分好转组(n=121)和恶化组(n=48)。比较2组的一般资料、实验室指标等。应用多因素logistic回归分析各因素对脓毒症病人病情恶化的影响,应用ROC曲线分析P(cv-a)CO_(2)/C(a-cv)O_(2)等因素预测脓毒症病人病情恶化的价值。结果:2组年龄、性别、WBC、CRP等临床资料对比差异均无统计学意义(P>0.05)。恶化组APACHEⅡ评分、PCT、LAC、P(cv-a)CO_(2)和P(cv-a)CO_(2)/C(a-cv)O_(2)均高于好转组(P<0.01),C(a-cv)O_(2)低于好转组(P<0.01)。多因素logistic回归分析显示,APACHEⅡ评分、LAC、P(cv-a)CO_(2)和P(cv-a)CO_(2)/C(a-cv)O_(2)是影响脓毒症病人病情恶化的独立危险因素(P<0.01)。ROC曲线显示,P(cv-a)CO_(2)/C(a-cv)O_(2)预测脓毒症病人病情恶化的诊断效能高于APACHEⅡ评分、LAC和P(cv-a)CO_(2)的预测价值(P<0.05),其最佳截点为>2.05 mmHg/mL,此时诊断的敏感性为72.93%、特异性为82.64%。结论:P(cv-a)CO_(2)/C(a-cv)O_(2)能有效预测脓毒症病人发生病情恶化的风险。
Objective:To analyze the correlation between the central venous-arterial partial pressure of carbon dioxide/artery-central venous blood oxygen content [P(cv-a)CO_(2)/C(a-cv)O_(2)] and the risk of sepsis.Methods:A total of 169 sepsis patients were divided into the improved group(n=121) and deteriorated group(n=48) according to the outcome of treatment.The general data and laboratory indicators of the two groups were compared.Multivariate logistic regression was used to analyze the effect of various factors on the deterioration of sepsis patients, and ROC curve was used to analyze the value of P(cv-a)CO_(2)/C(a-cv)O_(2) and other factors in predicting the deterioration of sepsis patients.Results:There was no significant difference in age, gender, WBC,CRP and other clinical data between the two groups(P>0.05).But the APACHEⅡ score, PCT,LAC,P(cv-a)CO_(2) and P(cv-a)CO_(2)/C(a-cv)O_(2) in the deteriorated group were higher than those in improved group(P<0.01),and C(a-cv)O_(2) was lower than that in the improved group(P<0.01).Multiariable logistic regression analysis showed that the APACHEⅡ score, LAC,P(cv-a)CO_(2) and P(cv-a)CO_(2)/C(a-cv)O_(2) was the independent risk factors affecting the progression of sepsis patients(P<0.01).ROC curve showed that the effectiveness of P(cv-a)CO_(2)/C(a-cv)O_(2) predicting the progression of the disease in the diagnosis of sepsis patients was significantly higher than the APACHEⅡ score, LAC and the predictive value of P(cv-a)CO_(2)(P<0.05),the best cutoff value was >2.05 mmHg/mL with the combined diagnostic sensitivity of 72.93%,specificity of 82.64%.Conclusions:P(cv-a)CO_(2)/C(a-cv)O_(2) can effectively predict the risk of disease deterioration in patients with sepsis.
作者
黄伟
马耀
孙风来
裴学勇
HUANG Wei;MA Yao;SUN Feng-lai;PEI Xue-yong(ICU,People′s Hospital of Maanshan,Maanshan Anhui 243000,China)
出处
《蚌埠医学院学报》
CAS
2022年第8期1057-1061,共5页
Journal of Bengbu Medical College
