首页|舌下微循环灌注血管比例变化率联合血清多配体蛋白聚糖-1水平对脓毒症休克并急性呼吸窘迫综合征预后的预测价值

舌下微循环灌注血管比例变化率联合血清多配体蛋白聚糖-1水平对脓毒症休克并急性呼吸窘迫综合征预后的预测价值

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的:探讨舌下微循环灌注血管比例变化率(ΔPPV)联合血清多配体蛋白聚糖-1(SDC-1)水平对脓毒症休克并急性呼吸窘迫综合征(ARDS)预后的预测价值.方法:选取2021 年10 月至2023 年1 月入住本院呼吸重症监护病房的脓毒症休克并ARDS患者,采集确诊后0、6、24 和72h的外周血,检测SDC-1、乳酸(Lac)等实验室指标,并收集相同时间点的舌下微循环图像,计算得到ΔPPV、乳酸清除率(LCR);分别于0、24 h和72h行序贯器官衰竭(SOFA)评分.根据28d生存情况分为生存组和死亡组.选取2 组间单因素分析有意义的变量及72 h ΔPPV联合SDC-1 绘制ROC曲线,分析上述指标预测脓毒症休克并ARDS患者 28d内死亡的价值.结果:ROC分析结果显示,24 h SDC-1、LCR,72 h SOFA评分、ΔPPV、SDC-1 及72 h ΔPPV联合SDC-1 对预后有预测价值(P均<0.05),其中72 h ΔPPV联合SDC-1 曲线下面积最大[AUC(95%CI)为 0.832(0.721～0.943)],敏感度为 0.931,特异度为0.680.结论:72 h ΔPPV联合SDC-1 比单一指标对脓毒症休克并ARDS预后具有更高的预测价值.
Predictive value of proportion of perfusion vessel change rate of sublin-gual microcirculation combined with serum syndecan-1 level for prognosis of patients with septic shock and ARDS
Aim:To investigate the prognosis predictive value of sublingual microcirculation proportion of perfusion vessel change rate(ΔPPV)combined with serum syndecan-1(SDC-1)in patients with septic shock and acute respiratory distress syndrome(ARDS).Methods:The peripheral blood of patients with septic shock and ARDS admitted to the Respira-tory Intensive Care Unit of our hospital from October 2021 to January 2023 were collected for testing SDC-1,lactate,and other laboratory indicators in the first 3 days(0,6,24 and 72 hours),sublingual microcirculation images were collected at the same time,and ΔPPV and lactate clearance rate(LCR)were calculated.Sequential organ failure(SOFA)scores were assessed within the first 3 days(0,24,and 72 hours),respectively.The patients were allocated into 2 groups according to their survival status within 28 days.The different indicators between the 2 groups and 72 hour ΔPPV +SDC-1 were chosen,and the receiver operating characteristic curve(ROC)was used to analyze the predictive value of the above indicators for death within 28 days in patients with septic shock and ARDS.Results:ROC analysis showed that 24 hour SDC-1,24 hour LCR,72 hour SOFA score,72 hour ΔPPV,72 hour SDC-1,and 72 hour ΔPPV + SDC-1 had predictive value for prognosis(all P<0.05);among them,the area under the curve(AUC)of 72 hour ΔPPV combined with SDC-1 was the largest[AUC(95%CI)=0.832(0.721-0.943)],with sensitivity of 0.931 and specificity of 0.680.Conclusion:72 hour ΔPPV com-bined with SDC-1 have a higher predictive value than single indicator for the prognosis of patients with septic shock and ARDS.

septic shockacute respiratory distress syndromesublingual microcirculationproportion of perfusion ves-sel change ratesyndecan-1

黄淑雅、李双凤、张磊、董睿、张瑞霞、高延秋

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郑州大学附属郑州中心医院呼吸重症医学科 郑州 450002

脓毒症休克 急性呼吸窘迫综合征 舌下微循环 灌注血管比例变化率 多配体蛋白聚糖-1

河南省科技攻关计划河南省医学科技攻关计划联合共建项目河南省医学科技攻关计划联合共建项目河南省高等学校重点科研项目

182102310177LHGJ20210778LHGJ2020077223A320036

2024

10.13705/j.issn.1671-6825.2023.06.062

郑州大学学报(医学版)
郑州大学

郑州大学学报(医学版)

CSTPCD北大核心
影响因子：1.246
ISSN：1671-6825
年,卷(期)：2024.59(2)
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