摘要
目的探讨外周血血管性血友病因子(vWF)、中性粒细胞/淋巴细胞比值(NLR)联合氧合指数(OI)预测脓毒症病人发生急性肺损伤的价值。方法2021年1月—2023年12月,选取在海安市人民医院治疗的脓毒症并发急性肺损伤病人88例为观察组,同时选取单纯脓毒症病人100例为对照组,对其临床资料进行回顾性分析。比较两组病人外周血vWF、NLR和OI等差异,以及分析不同危险程度急性肺损伤病人外周血vWF、NLR和OI差异,并分析外周血vWF与NLR及OI预测脓毒症发生急性肺损伤的价值。结果观察组vWF、NLR和急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分均明显高于对照组,而OI则明显低于对照组,差异均具有统计学意义(t=-8.412~16.030,P<0.001)。观察组中高危病人的vWF和NLR均明显高于低危者,而OI则明显低于低危者,差异均有显著性(t=-5.160~10.172,P<0.001)。外周血vWF、NLR与APACHEⅡ评分均呈正相关,而OI与APACHEⅡ评分则呈负相关,差异均有显著意义(r=-0.750~0.801,P<0.05)。外周血vWF、NLR和OI单独以及联合预测脓毒症急性肺损伤的ROC曲线下面积分别为0.796、0.815、0.843和0.712,其中以联合预测的灵敏度(88.5%)最高。结论外周血vWF、NLR和OI与脓毒症急性肺损伤病情严重程度存在相关性,三者单独及其联合预测脓毒症并发急性肺损伤均有一定价值。
Objective To investigate the value of peripheral blood von Willebrand factor(vWF),neutrophil-lymphocyte ratio(NLR),and oxygenation index(OI)in predicting acute lung injury in patients with sepsis.Methods A total of 88 patients with sepsis and acute lung injury who were treated in Haian People′s Hospital from January 2021 to December 2023 were enrolled as observation group,and 100 patients with sepsis alone were enrolled as control group.A retrospective analysis was performed for their clinical data,and peripheral blood vWF,NLR,and OI were compared between the two groups.The differences in peripheral blood vWF,NLR,and OI were compared between patients with different risk levels of acute lung injury,and the value of peripheral blood vWF,NLR,and OI in predicting acute lung injury in sepsis was analyzed.Results Compared with the control group,the observation group had significantly higher vWF,NLR,and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score and a significantly lower OI(t=-8.412 to 16.030,P<0.001).In the observation group,the high-risk patients had significantly higher vWF and NLR and a significantly lower OI than the low-risk patients(t=-5.160 to 10.172,P<0.001).Peripheral blood vWF and NLR were positively correlated with APACHEⅡscore,while OI was negatively correlated with APACHEⅡscore(r=-0.750 to 0.801,P<0.05).Peripheral blood vWF,NLR,and OI used alone or in combination had an area under the ROC curve of 0.796,0.815,0.843,and 0.712,respectively,in predicting acute lung injury in sepsis,and the combination of the three indicators had the highest sensitivity of 88.5%.Conclusion Peripheral blood vWF,NLR,and OI are correlated with the severity of acute lung injury in patients with sepsis,and these three indicators used alone or in combination have a certain value in predicting acute lung injury in patients with sepsis.
作者
朱然
ZHU Ran(Department of Critical Care Medicine,Haian People′s Hospital,Haian 226600,China)
出处
《青岛大学学报(医学版)》
2025年第2期234-238,共5页
Journal of Qingdao University(Medical Sciences)
基金
江苏省青年医学重点人才培养项目(QNRC2016-504)。
