摘要
目的 探讨肺超声(LUS)、X线联合实验室指标预测新型冠状病毒肺炎(COVID-19)危重型患者预后的临床价值。方法 选取收治于贵州医科大学附属医院重症监护病房的COVID-19危重症患者63例,入院后均行床旁LUS(八分区)、X线检查分别获取LUS评分及X线评分。根据入重症监护病房30 d后患者情况将其分为死亡组40例和存活组23例,比较两组患者LUS评分、X线评分及实验室指标的差异;应用Logistic回归分析筛选预测COVID-19危重型患者预后的影响因素。绘制受试者工作特征(ROC)曲线分析各影响因素单独及联合应用预测COVID-19危重型患者预后的诊断效能。结果 死亡组白细胞计数、血二氧化碳分压(PCO_(2))、LUS评分及X线评分均高于存活组,血氧饱和度、淋巴细胞百分比(LYM%)、酸碱度(pH值)均低于存活组,差异均有统计学意义(均P<0.05)。单因素Logistic回归分析显示,LUS评分、X线评分、pH值、PCO_(2)、LYM%均为预测COVID-19危重型患者预后的影响因素(OR=1.22、1.31、0.00、1.08、0.88,均P<0.05)。ROC曲线分析显示,X线评分、LUS评分、PCO_(2)三者联合应用预测COVID-19危重症患者预后的曲线下面积为0.791,均高于其单独应用(0.696、0.708、0.715)。结论 LUS评分、X线评分、PCO_(2)均可用于预测COVID-19危重型患者预后,且三者联合预测的诊断效能更高。
Objective To investigating the clinical value of lung ultrasound(LUS)and X-ray combined with laboratory indices in predicting the prognosis of critical patients with coronavirus disease 2019(COVID-19).Methods Sixty-three COVID-19 critically ill patients admitted to the intensive care unit of the Affiliated Hospital of Guizhou Medical University were selected.Bedside LUS(8-zone)and X-ray were performed,the LUS score and X-ray score were obtained after admission.They were divided into 40 cases in the death group and 23 cases in the survival group according to patients’condition after 30 d in the intensive care unit.The LUS score,X-ray score and laboratory indexes were compared between the two groups.Logistic regression analysis was used to evaluate the influencing factors of critically ill patients with COVID-19.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of each influencing factors alone and jointly to predict the prognosis of COVID-19 critically ill patients.Results Leukocyte count,partial pressure of carbon dioxide(PCO_(2)),LUS score and X-ray score were higher in the death group than those in the survival group,and oxygen saturation,the percentage of lymphocytes(LYM%)and acidity and alkalinity(pH)were lower than those in the survival group,the differences were statistically significant(all P<0.05).Logistic regression analysis showed that LUS score,X-ray score,pH,PCO_(2) and LYM%were influencing factors in predicting the prognosis in COVID-19 critically ill patients(OR=1.22,1.31,0.00,1.08,0.88,all P<0.05).ROC curve analysis showed that the the area under the curve of the combination of X-ray score,LUS score and PCO_(2) for predicting the prognosis of COVID-19 critical ill patients was 0.791,which was higher than the prediction efficacy alone(0.696,0.708 and 0.715).Conclusion LUS score,X-ray score and PCO_(2) can be used to predict the prognosis of COVID-19 critically ill patients,and their combined prediction has higher diagnostic efficacy.
作者
吴明翠
王若雁
张莉
赵丽娜
李莎
张蓓
WU Mingcui;WANG Ruoyan;ZHANG Li;ZHAO Li’na;LI Sha;ZHANG Bei(Guizhou Medical University,Guiyang 550004,China)
出处
《临床超声医学杂志》
CSCD
2024年第5期370-374,共5页
Journal of Clinical Ultrasound in Medicine
基金
国家自然科学基金项目(81960315)。
关键词
超声检查
肺
X线
新型冠状病毒肺炎
危重症
预后
Ultrasonography,lung
X-ray
Coronavirus disease 2019
Critical illness
Prognosis
