【摘要】 目的评估肺损伤预测评分(LIPS)在早期预测急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)中的价值和可行性。方法对43例ALI/ARDS患者和32例非ALI/ARDS患者分别进行LIPS、肺损伤评分(LIS)和急性生理学及慢性健康状况(APACHE)Ⅱ评分,计算两组病死率,并对结果进行比较和相关性分析,利用受试者工作特征(ROC)曲线评价LIPS和LIS的诊断分辨度。结果与非ALI/ARDS组相比,ALI/ARDS组的ICU平均住院时间、LIPS和LIS较高,而PaO2/FiO2相对较低,且病死率高达34.88%。LIPS与LIS呈明显正相关(r=0.669,P<0.001),但LIPS、LIS与APACHEⅡ评分间的相关性不强(r分别为0.460和0.342,P<0.05)。LIPS评分对预测ALI/ARDS有意义[曲线下面积(AUC)=0.832,95%CI:0.728～0.908,P<0.001],当LIPS>7分时,预测ALI/ARDS的敏感度为83.72%,特异性为78.12%。LIS评分对预测ALI/ARDS也有意义(AUC=0.802,95%CI:0.693～0.885,P<0.001),LIS>0.67分时,预测ALI/ARDS的敏感度、特异性分别为81.40%和77.80%。结论 LIPS对预测ALI/ARDS的准确性较好,且与LIS系统具有较好的相关性,早期即可获得,临床操作性较强,该评分系统为早期预测ALI/ARDS提供了可能。更多还原

【Abstract】 Objective To evaluate the value and feasibility of lung injury prediction score(LIPS) in early identification of ALI/ARDS.Methods The clinical data of 43 ALI/ARDS patients and 32 non-ALI / ARDS patients was collected and evaluated with LIPS,lung injury score(LIS) and APACHE Ⅱ score system.Mortality of two groups and correlation analysis were evaluated.The forecast value of LIPS and LIS in diagnosis of ALI/ARDS was analyzed by receiver operator characteristic(ROC) curve.Results Compared with non-ALI /ARDS group,the average hospitalization days in ICU,LIPS and LIS of ALI / ARDS group were significantly higher,but the PaO2 / FiO2 was lower.Furthermore,the mortality of ALI/ARDS group was very high(34.88%).The LIPS of patients had positive correlation with the LIS(r=0.669,P<0.001),but LIPS and LIS of patients had no obvious correlation with APACHEⅡ(r=0.460 and 0.342,P<0.005).A receiver operator characteristic curve analysis showed that LIPS predicted ALI/ARDS(the area under the curve(AUC)=0.832,95% CI:0.728～0.908,P<0.001)and LIS predicted ALI/ARDS(AUC= 0.802,95% CI:0.693～0.885,P<0.001).The sensitivity and specificity of LIPS were respectively 83.72% and 78.12% when LIPS>7 points;while the sensitivity and specificity of LIS was 81.40% and 77.80% when LIS>0.67 points.Conclusion The accuracy of LIPS system to predict ALI/ARDS was better.LIPS system has a positive correlation with the LIS system,and the score parameters are easy to be obtained,so it would be possible to apply LIPS system for early identification of patients at risk of ALI/ARDS.更多还原