中国当代医药2025，Vol.32Issue(12)：4-7,12,5.DOI:10.3969/j.issn.1674-4721.2025.12.01
人类免疫缺陷病毒合并肺部感染患者并发急性呼吸窘迫综合征的风险预警模型构建与验证
Construction and verification of risk warning model for acute respiratory distress syndrome in patients with human immunodeficiency virus com-plicated with pulmonary infection
摘要
Abstract
Objective To analyze the risk factors related to acute respiratory distress syndrome(ARDS)in patients with hu-man immunodeficiency virus(HIV)complicated with pulmonary infection,and establish an early warning model and validation.Methods A total of 127 patients with HIV complicated with pulmonary infection admitted to Jiangxi Chest Hos-pital from December 2021 to December 2023 were selected as the research objects,and they were divided into ARDS group(n=38)and non-ARDS group(n=89)according to whether they were complicated with ARDS.Clinical baseline data of pa-tients were collected,univariate analysis and multivariate logistic regression analysis were performed to determine independent predictors,and ROC curve was used to evaluate the efficacy of the prediction model.The clinical data of another 45 patients were selected for external validation of the model.Results Univariate analysis results showed that there were significant differences in gender,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),sequential organ failure score(SOFA),oxygenation index and C-reactive protein(CRP)between two groups(P＜0.05).The results of multi-variate analysis showed that APACHE Ⅱ(β=0.100,OR=1.106,95％CI:1.016-1.204),SOFA(β=0.199,OR=1.220,95％CI:1.006-1.479)and CRP(β=0.071,OR=1.074,95％CI:1.027-1.123)were independent risk factors for ARDS in pa-tients with HIV complicated with pulmonary infection(P＜0.05).Male(β=-1.891,OR=0.151,95％CI:0.049-0.470)and oxygenation index(β=-0.014,OR=0.986,95％CI:0.977-0.996)were independent protective factors for ARDS in patients with HIV complicated with pulmonary infection(P＜0.05).The area under ROC curve of the prediction model was 0.845,the sensitivity was 0.789,the specificity was 0.775,and the maximum approximate entry index was 0.564.A total of 45 patients in the verification group were substituted into the prediction model,the area under ROC curve was 0.860,and the maximum approximate entry index was 0.592.The model had good goodness of fit and good clinical prediction efficiency.Conclusion High levels of APACHE Ⅱ,SOFA and CRP are independent risk factors for ARDS in patients with HIV complicated with pulmonary infection,and male and high oxygenation index are independent protective factors.The risk warning model established in this study can effectively predict ARDS and help to take intervention measures in advance to reduce the risk.关键词
人类免疫缺陷病毒/肺部感染/急性呼吸窘迫综合征/风险预警模型Key words
Human immunodeficiency virus/Pulmonary infection/Acute respiratory distress syndrome/Risk warning model分类
医药卫生引用本文复制引用
吴金,宗佩兰,叶玲,朱春琳..人类免疫缺陷病毒合并肺部感染患者并发急性呼吸窘迫综合征的风险预警模型构建与验证[J].中国当代医药,2025,32(12):4-7,12,5.基金项目
中央引导地方科技发展资金项目(20221ZDG020069) （20221ZDG020069）
江西省临床医学研究中心组建项目(2020BCG74004). （2020BCG74004）
