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肝脾比是预测新冠病毒肺炎患者氧气需求的一个风险因素。

The liver-to-spleen ratio is a risk factor predicting oxygen demand in COVID-19 patients.

作者信息

Nakayasu Hiromasa, Sakurai Shogo, Sugiyama Shuichi, Shiratori Kotaro, Okawa Kohei, Kitahara Yoshihiro, Takahashi Shingo, Masuda Toshihiro, Kishimoto Yutaro, Saigusa Mika, Yamamoto Akito, Akamatsu Taisuke, Morita Satoru, Asada Kazuhiro, Shirai Toshihiro

机构信息

Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, 420-0805 Shizuoka, Japan.

出版信息

Infect Med (Beijing). 2023 Jun;2(2):105-111. doi: 10.1016/j.imj.2023.04.002. Epub 2023 Apr 20.

Abstract

BACKGROUND

We aimed to investigate risk factors predicting oxygen demand in COVID-19 patients.

METHODS

Patients admitted to Shizuoka General Hospital with COVID-19 from August 2020 to August 2021 were included. First, we divided patients into groups with and without oxygen demand. Then, we compared patients' clinical characteristics and laboratory and radiological findings to determine factors predicting oxygen demand.

RESULTS

One hundred seventy patients with COVID-19 (aged 58±15 years, 57 females) were enrolled. Common comorbidities were cardiovascular diseases (47.6%), diabetes mellitus (28.8%), and dyslipidemia (26.5%). Elder age, higher body mass index, cardiovascular diseases, diabetes mellitus, lower lymphocyte count, albumin, hepatic attenuation value, and the liver-to-spleen ratio (L/S), higher D-dimer, aspartate aminotransferase, lactate dehydrogenase, troponin-T, C-reactive protein, KL-6, chest and abdominal circumference, and visceral fat were found in patients with oxygen demand. According to the multivariate logistic regression analysis, L/S, lymphocyte count, D-dimer, and abdominal circumference under the diaphragm were independent risk factors predicting oxygen demand in COVID-19 patients.

CONCLUSIONS

On admission, L/S, lymphocyte count, D-dimer, and abdominal circumference were predictive factors for oxygen demand. These factors may help in the appropriate triage of COVID-19 patients in the decision to admit them to the hospital.

摘要

背景

我们旨在研究预测新冠肺炎患者氧气需求的风险因素。

方法

纳入2020年8月至2021年8月入住静冈综合医院的新冠肺炎患者。首先,我们将患者分为有氧气需求组和无氧气需求组。然后,我们比较患者的临床特征、实验室检查和影像学检查结果,以确定预测氧气需求的因素。

结果

共纳入170例新冠肺炎患者(年龄58±15岁,女性57例)。常见合并症有心血管疾病(47.6%)、糖尿病(28.8%)和血脂异常(26.5%)。有氧气需求的患者年龄较大、体重指数较高、患有心血管疾病、糖尿病、淋巴细胞计数较低、白蛋白水平较低、肝脏衰减值较低、肝脾比(L/S)较低、D-二聚体水平较高、天冬氨酸转氨酶水平较高、乳酸脱氢酶水平较高、肌钙蛋白-T水平较高、C反应蛋白水平较高、KL-6水平较高、胸围和腹围较大以及内脏脂肪较多。根据多因素逻辑回归分析,L/S、淋巴细胞计数、D-二聚体和膈下腹部周长是预测新冠肺炎患者氧气需求的独立危险因素。

结论

入院时,L/S、淋巴细胞计数、D-二聚体和腹部周长是氧气需求的预测因素。这些因素可能有助于在决定收治新冠肺炎患者时进行适当的分诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e2b/10699702/65cdd6da0fa5/ga1.jpg

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