摘要
目的:探讨肺部超声评分(LUS)和血清谷氨酸转移酶对急性肺损伤患者病情严重程度及预后的评估价值。方法:选择2020年5月至2021年11月在我院进行治疗的107例急性肺损伤患者作为研究对象,收集患者一般资料,进行急性生理与慢性健康状况Ⅱ评分(APACHEⅡ),依据评分将患者分为病情轻度组(31例)、中度组(52例)及重度组(24例)。以患者入院诊断急性肺损伤为研究起点,患者病死或治愈出院为研究终点,将其分为病死组(32例)与治愈组(75例),行肺部超声检查,并进行评分。收集患者血清,检测血清谷氨酸转移酶水平。分析各组患者LUS及血清谷氨酸转移酶水平的差异,采用多因素Logistic风险回归模型分析影响患者预后的独立风险因素,并借助受试者工作特征(ROC)曲线做进一步评估。结果:重度患者的肺部超声评分显著高于轻度与中度患者,且中度患者的肺部超声评分显著高于轻度患者(P均<0.05)。与病死组比较,治愈组的氧合指数高,APACHEⅡ评分与LUS低,谷氨酸转移酶水平下降,差异均有统计学意义(P均<0.05)。Logistic风险回归模型分析结果显示LUS、谷氨酸转移酶、氧合指数、APACHEⅡ评分均是影响患者预后的独立因素,其中氧合指数OR<1,被评估为保护因素,LUS、谷氨酸转移酶、APACHEⅡ评分OR>1,被评估为危险因素。LUS与谷氨酸转移酶水平联合预测患者预后的AUC显著高于单项LUS或谷氨酸转移酶的AUC(P均<0.05)。结论:LUS、血清谷氨酸转移酶与急性肺损伤患者病情严重程度及预后显著相关,对患者病情严重程度及预后具有评估价值,两者联合评估价值更高。
Objective:To investigate the value of lung ultrasound score(LUS)and serum glutamate transferase in evaluating the severity and prognosis of patients with acute lung injury.Methods:A total of 107 patients with acute lung injury who were treated in our hospital from May 2020 to November 2021 were selected for research.The general information of the patients was collected,and the acute physiology and chronic health evaluationⅡscore(APACHEⅡ)was performed.According to the score,patients were divided into mild group(31 cases),moderate group(52 cases)and severe group(24 cases).Taking patients diagnosed as acute lung injury on admission as the starting point of the study and death or cure and discharge as the end point of the study,they were divided into death group(32 cases)and cured group(75 cases).Lung ultrasonography and scoring were performed.Serum was collected from patients to detect serum glutamate transferase levels.The differences in LUS and serum glutamate transferase levels of patients in each group were analyzed,and the independent risk factors affecting the prognosis of patients were analyzed by multivariate Logistic risk regression model,and the receiver operating characteristic curve(ROC)was used for further evaluation.Results:The levels of LUS in severe patients were significantly higher than those in mild and moderate patients,and the levels of LUS in moderate patients were significantly higher than those in mild patients(all P<0.05).Compared with the death group,the cured group had higher oxygenation index,lower APACHEⅡscore and LUS,and lower glutamate transferase levels(all P<0.05).Logistic risk regression model showed that LUS,glutamate transferase,oxygenation index and APACHEⅡscore were independent factors affecting the prognosis of patients,among which oxygenation index OR<1 was assessed as a protective factor,while LUS,glutamate transferase and APACHEⅡscore OR>1 was assessed as a risk factor.The AUC of LUS combined with glutamate transferase to predict the prognosis of patients was signi
作者
甘惠玲
张步瑶
李静
徐瑞敏
陈妹花
GAN Hui-ling;ZHANG Bu-yao;LI Jing(Department of Intensive Care Unit,the Second Affiliated Hospital of Hainan Medical College,Haikou 570216,China)
出处
《放射学实践》
CSCD
北大核心
2023年第5期641-645,共5页
Radiologic Practice
基金
2018年度海南省卫生计生行业科研项目(18A200046)。
关键词
肺部超声评分
超声检查
谷氨酸转移酶
急性肺损伤
预后评估
Lung ultrasound score
Ultrasonography
Glutamate transferase
Acute lung injury
Prognosis assessment
