摘要
Abstract
Objective To evaluate the value of modified ROX(mROX)index,serum nitric oxide synthase(NOS)and lactate dehydrogenase(LDH)in predicting the outcomes of patients with acute respiratory dis-tress syndrome(ARDS)caused by severe pulmonary infection undergoing transnasal high flow oxygen thera-py(HFNC).Methods A retrospective analysis was conducted on the clinical data of 150 critically ill patients with ARDS caused by severe pulmonary infection who received HFNC treatment in the intensive care unit of Zhangjiagang City First People's Hospital from January 2022 to December 2023.According to the clinical out-comes of patients at 28 days,they were divided into HFNC successful group and HFNC failed group.Collect the mROX index,serum NOS level,LDH level and other relevant clinical parameters of patients upon admis-sion.Compare clinical data,mROX index and laboratory testing indicators between the two groups.Using multivariate Logistic regression analysis to investigate the influencing factors of mROX index,NOS and LDH on the outcome of HFNC treatment in ARDS patients caused by severe pulmonary infection.The receiver op-erating characteristic(ROC)curve was used to evaluate the predictive efficacy of mROX index,NOS,LDH a-lone and their combined detection for the outcome of HFNC treatment in ARDS patients caused by severe pul-monary infection.Results A total of 150 patients were divided into HFNC success group and HFNC failure group based on 28 day clinical outcomes,with 85 and 65 cases respectively.The comparison of mROX index,NOS,LDH,C-reactive protein(CRP),procalcitonin(PCT)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score between the two groups showed statistically significant differences(P<0.05).The results of multivariate Logistic regression analysis showed that APACHEⅡ score,mROX index,NOS and LDH were all influencing factors on the outcome of HFNC treatment in ARDS patients caused by severe pul-monary infection(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of mROX index,NOS,LDH and their combined detection for predicting the treatment outcome of ARDS patients caused by severe pulmonary infection were 0.848,0.815,0.808 and 0.901 respectively.The AUC of the com-bined detection was significantly greater than that of each indicator detected separately(P<0.05).Conclusion The combined detection of mROX index,NOS and LDH has high sensitivity and specificity in predicting the outcome of HFNC treatment in ARDS patients with severe pulmonary infection.It can predict the outcome of patients earlier and more accurately,which helps clinicians optimize intervention measures dur-ing the treatment process and improve patient prognosis.关键词
改良ROX/一氧化氮合酶/乳酸脱氢酶/经鼻高流量氧疗/肺部感染/急性呼吸窘迫综合征Key words
modified ROX/nitric oxide synthase/lactate dehydrogenase/transnasal high flow oxy-gen therapy/pulmonary infection/acute respiratory distress syndrome分类
临床医学
