肺超声、X线联合实验室指标预测新型冠状病毒肺炎危重型患者预后的临床价值
Clinical value of lung ultrasound and X-ray combined with laboratory indices in predicting the prognosis of critical patients with coronavirus disease 2019
吴明翠 1王若雁 2张莉 3赵丽娜 4李莎 4张蓓4
作者信息
- 1. 550004 贵阳市,贵州医科大学
- 2. 六盘水市人民医院超声医学科
- 3. 六盘水市第三人民医院超声医学科
- 4. 贵州医科大学附属医院超声中心
- 折叠
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30d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(PCO2)、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、PCO2、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、PCO2三者联合应用预测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、PCO2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.
Abstract
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(PCO2),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,PCO2 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 PCO2 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 PCO2 can be used to predict the prognosis of COVID-19 critically ill patients,and their combined prediction has higher diagnostic efficacy.
关键词
超声检查,肺/X线/新型冠状病毒肺炎/危重症/预后Key words
Ultrasonography,lung/X-ray/Coronavirus disease 2019/Critical illness/Prognosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据