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肺泡-动脉氧梯度:预测儿童社区获得性肺炎严重程度的早期标志物。

Alveolar-arterial oxygen gradient: An early marker to predict the severity of community-acquired pneumonia in children.

机构信息

Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou, China.

出版信息

Medicine (Baltimore). 2024 Apr 5;103(14):e37670. doi: 10.1097/MD.0000000000037670.

Abstract

To study the clinical significance of alveolar-arterial oxygen gradient (PA-aO2) for children with community-acquired pneumonia (CAP). A prospective study was carried out from January 2020 to June 2023, Overall, 100 patients were included in the study, 35 had severe pneumonia, whereas, 65 had non-severe pneumonia. Clinical and laboratory data were retrospectively collected at the time of hospital admission and during hospitalization. Patients were divided into severe and non-severe groups. PA-aO2 was significantly higher among children with severe pneumonia, as determined by WHO, PRESS (P < .001). PA-aO2 was significantly higher among children with mechanical ventilation, shock, sepsis, and mortality. Receiver operating characteristic curve (ROC) analysis for PA-aO2 showed that the area under the curve was 0.76 (P value < .05), with a sensitivity of 84.3% and a specificity of 67.9%. Our study suggests that PA-aO2 level has a predictive value for detecting community-acquired pneumonia severity in children.

摘要

目的

研究社区获得性肺炎(CAP)患儿肺泡-动脉氧梯度(PA-aO2)的临床意义。

方法

本研究为前瞻性研究,时间为 2020 年 1 月至 2023 年 6 月,共纳入 100 例患者,其中 35 例为重症肺炎,65 例为非重症肺炎。入院时和住院期间回顾性收集临床和实验室数据。根据世界卫生组织(WHO)和 PRESS 评分标准,将患者分为重症组和非重症组。

结果

重症肺炎患儿的 PA-aO2 显著高于非重症肺炎患儿(P <.001)。机械通气、休克、脓毒症和死亡的患儿 PA-aO2 更高。PA-aO2 的受试者工作特征曲线(ROC)分析显示,曲线下面积为 0.76(P 值 <.05),灵敏度为 84.3%,特异性为 67.9%。

结论

PA-aO2 水平对儿童社区获得性肺炎严重程度具有预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26cf/10994442/3fb8bc1d7340/medi-103-e37670-g001.jpg

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