联合LIPS和APACHE Ⅱ评分对重症创伤性脑损伤患者合并急性肺损伤的预测价值OA
Predictive value of combined LIPS and APACHE Ⅱ scores in patients with severe traumatic brain injury complicated with acute lung injury
目的 探讨肺损伤预测评分(lung injury prediction score,LIPS)联合急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)评分对重症创伤性脑损伤(severe traumatic brain injury,sTBI)患者合并急性肺损伤(acute lung injury,ALI)的预测价值.方法 回顾性选取 2019 年 1 月至 2021 年 12 月安徽医科大学附属省立医院收治的 75 例sTBI患者,根据是否合并ALI,将其分为ALI组(n=24)和非ALI组(n=51).收集患者入院时的基本资料、实验室指标、APACHE Ⅱ评分、LIPS评分、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分;采用Logistic回归分析sTBI患者合并ALI的危险因素,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评价指标对sTBI合并ALI的预测价值.结果 ALI组患者的APACHE Ⅱ评分、LIPS评分均显著高于非ALI组,GCS评分、红细胞体积分布宽度显著低于非ALI组(P<0.05).Logistic回归分析显示,APACHEⅡ评分和LIPS评分升高及GCS评分降低均是sTBI合并ALI的独立危险因素(P<0.05).ROC曲线分析显示,LIPS评分、APACHE Ⅱ评分诊断sTBI合并ALI的曲线下面积(area under the curve,AUC)分别为 0.869 和 0.754;二者联合检测的AUC为 0.916(95％CI:0.855～0.976),敏感度和特异性分别为 83.4％和 84.3％.结论 LIPS评分联合APACHE Ⅱ评分可有效预测sTBI合并ALI的风险.
Objective To investigate predictive value of combined lung injury prediction score(LIPS)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores in patients with severe traumatic brain injury(sTBI)complicated with acute lung injury(ALI).Methods Seventy-five sTBI patients admitted to Provincial Hospital of Anhui Medical University from January 2019 to December 2021 were retrospectively selected and divided into ALI group(n=24)and non-ALI group(n=51)according to whether they were complicated with ALI.Basic data,laboratory indicators,APACHE Ⅱ score,LIPS score and Glasgow coma scale(GCS)score were collected.Logistic regression was used to analyze the risk factors of patients with sTBI complicated with ALI,and predictive value of the evaluation index of the receiver operating characteristic(ROC)curve for sTBI complicated with ALI was drawn.Results APACHE Ⅱ score and LIPS score in ALI group were significantly higher than those in non-ALI group,GCS score and red cell volume distribution width were significantly lower than those in non-ALI group(P<0.05).Logistic regression analysis showed that APACHE Ⅱ score,LIPS score and GCS score were independent risk factors for sTBI complicated with ALI(P<0.05).ROC curve analysis showed that area under the curve(AUC)of LIPS score and APACHE Ⅱ score in the diagnosis of sTBI complicated with ALI were 0.869 and 0.754,respectively.The AUC was 0.916(95％CI:0.855-0.976),and the sensitivity and specificity were 83.4％and 84.3％,respectively.Conclusion LIPS score combined with APACHE Ⅱ score can effectively predict the risk of sTBI complicated with ALI.
许楠欣;周敏
安徽医科大学附属省立医院呼吸科,安徽合肥 230031安徽医科大学附属省立医院重症医学科,安徽合肥 230031
临床医学
创伤性脑损伤急性肺损伤肺损伤预测评分急性生理学和慢性健康状况评价Ⅱ危险因素
Traumatic brain injuryAcute lung injuryLung injury prediction scoreAcute physiology and chronic health evaluation ⅡRisk factor
《中国现代医生》 2024 (013)
32-35 / 4
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