国际老年医学杂志2024，Vol.45Issue(1)：11-17,7.DOI:10.3969/j.issn.1674-7593.2024.01.003
血乳酸及ROX指数在经鼻湿化高流量氧疗治疗高龄慢性阻塞性肺疾病急性加重期中的应用价值
Application Value of Blood Lactate and ROX Index in Humidification High-flow Nasal Cannula Oxygen Therapy for Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
摘要
Abstract
Objective To investigate the application value of blood lactic acid(Lac)and ROX index in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)by nasal humidification high-flow oxy-gen therapy(HFNC).Methods A total of 82 patients with AECOPD who visited the Department of Respiratory and Critical Care Medicine of the Second Medical Center of the PLA General Hospital from March 2020 to March 2023 were selected as the study sub-jects and treated with HFNC.Patients were divided into effective(n=53)and ineffective(n=29)groups according to the continu-ous treatment of HFNC for 48 h.The clinical data and serum Lac and ROX indices were compared between the two groups,and the related factors affecting the ineffective treatment of HFNC were analyzed by a mlogistic regression model,the predictive value of blood Lac and ROX indices for the ineffective treatment of HFNC was analyzed by ROC curve.Results The age,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,C-reactive protein(CRP),blood Lac before and 12 h after treatment in the in-effective group were all higher than those in the effective group(P＜0.05),and albumin(ALb)levels,oxygenation index,and ROX index before and 12 h after treatment were lower than those in the effective group(P＜0.05).Multivariate logistic regression a-nalysis showed that high APACHE Ⅱ score and high blood Lac before arid 12 h after treatment were risk factors affecting the ineffective treatment of HFNC(P＜0.05),and high ROX index before and 12 h after treatment were protective factor for the effective treatment of HFNC(P＜0.05).ROC curves showed that the AUC(95％CI)of blood Lac before treatment and 12 hours after treatment,ROX index before treatment and 12 hours after treatment for predicting ineffective HFNC treatment were 0.680(0.568～0.779),0.730(0.621～0.822),0.776(0.670～0.860),and 0.823(0.723～0.899),respectively.Conclusion High blood Lac level and low ROX index before and 12 h after HFNC treatment in elderly patients with AECOPD are risk factors affecting the failure of HFNC continuous treatment for 48 h,and blood Lac and ROX index before and 12 h after HFNC treatment can be used as a reliable reference index to evaluate the therapeutic effect of HFNC.关键词
慢性阻塞性肺疾病急性加重期/经鼻湿化高流量氧疗/血乳酸/ROX指数Key words
Acute exacerbation of chronic obstructive pulmonary disease/Nasal humidification high-flow oxygen therapy/Blood lactic acid/ROX index引用本文复制引用
杨玉梅,梁锡铭,孙志峰,来纯云,赵静..血乳酸及ROX指数在经鼻湿化高流量氧疗治疗高龄慢性阻塞性肺疾病急性加重期中的应用价值[J].国际老年医学杂志,2024,45(1):11-17,7.基金项目
国家重点研发计划课题项目(2020YFC2009003) （2020YFC2009003）
