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[改良肺超声通气损失评分在重症监护病房休克患者中的预后价值]

[Prognostic value of modified lung ultrasound aeration loss score in shock patient in intensive care unit].

作者信息

Zou T J, Yin M G, Qin Y, Li Y, Zeng X Y, Kang Y

机构信息

Department of Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University , Chengdu 610041, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Aug 1;97(29):2244-2247. doi: 10.3760/cma.j.issn.0376-2491.2017.29.002.

Abstract

To investigate the prognostic value of modified lung ultrasound aeration loss score(mLUS) in shock patients in intensive care unit(ICU). This was a prospective study.Shock patients who were admitted to ICU from April 2016 to August 2016 were eligible; 90 consecutive shock patients were enrolled.Chest ultrasound examination were done within the first 6 hours after included. The mLUS and other ultrasound variables were recorded as well as the clinical data and the outcome. Data has been analyzed, and a bivariate logistic regression model was established to identify the correlation between mLUS on admission and the ICU mortality. The mean APACHE Ⅱ score, lactate, mLUS were significantly increased in non-survivors while the PaO(2)/FiO(2) was decreased in these patients(=0.048, 0.000, 0.048, 0.000, 0.004). The univariate analysis revealed that the above variables were significantly related to ICU mortality.The multivariate analysis demonstrated that mLUS are the independent risk factors of ICU mortality as well as the lactate(=0.045, 0.006; AUC=0.733, 0.793, respectively). Modified lung ultrasound aeration loss score can predict the outcome of shock patients in ICU.

摘要

探讨改良肺超声通气损失评分(mLUS)在重症监护病房(ICU)休克患者中的预后价值。这是一项前瞻性研究。纳入2016年4月至2016年8月入住ICU的休克患者;连续纳入90例休克患者。在纳入后的前6小时内进行胸部超声检查。记录mLUS及其他超声变量以及临床数据和结局。对数据进行分析,建立二元逻辑回归模型以确定入院时mLUS与ICU死亡率之间的相关性。非存活者的平均急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、乳酸水平、mLUS显著升高,而这些患者的动脉血氧分压/吸入氧分数值(PaO₂/FiO₂)降低(P = 0.048、0.000、0.048、0.000、0.004)。单因素分析显示上述变量与ICU死亡率显著相关。多因素分析表明,mLUS以及乳酸是ICU死亡率的独立危险因素(P = 0.045、0.006;曲线下面积分别为0.733、0.793)。改良肺超声通气损失评分可预测ICU休克患者的结局。

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