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中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (05) : 654 -657. doi: 10.3877/cma.j.issn.1674-6902.2023.05.010

临床研究

急性低氧性呼吸衰竭乳酸/白蛋白比值与病死率相关性分析
程玲燕, 卢嘉宾, 韦庆, 兰祖()   
  1. 547000 河池,河池市人民医院·右江民族医学院附属河池医院呼吸与危重症医学科
  • 收稿日期:2023-02-02 出版日期:2023-10-25
  • 通信作者: 兰祖
  • 基金资助:
    河池市科技计划项目(河科AB193607)

Correlation analysis of lactate/albumin ratio and mortality in acute hypoxemic respiratory failure

Lingyan Chen, Jiabin Lu, Qing Wei   

  • Received:2023-02-02 Published:2023-10-25
引用本文:

程玲燕, 卢嘉宾, 韦庆, 兰祖. 急性低氧性呼吸衰竭乳酸/白蛋白比值与病死率相关性分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(05): 654-657.

Lingyan Chen, Jiabin Lu, Qing Wei. Correlation analysis of lactate/albumin ratio and mortality in acute hypoxemic respiratory failure[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(05): 654-657.

目的

分析乳酸/白蛋白比值(LAR)与急性低氧性呼吸衰竭(AHRF)病死率的相关性。

方法

选择2019年4月至2022年12月我院收治的AHRF患者39例为对象,主要结局随访60 d内全因病死率,分为预后不良14例及预后良好25例;次要结局院内病死率。检测动脉血乳酸水平,血清白蛋白水平,计算LAR。

结果

预后不良者LAR高[2.00(1.07,3.02)vs. 1.03(0.68,1.97),Z=-2.753,P=0.006]。ROC曲线分析显示LAR对AHRF 60 d内预测曲线下面积(AUC)0.873[95%置信区间:0.796~0.950]高于急性生理与慢性健康评分Ⅱ(APACHEⅡ)、简化急性生理学评分Ⅱ(SAPSⅡ)、序贯器官衰竭(SOFA)及动脉血氧分压/吸入气体氧含量(P/F)比值、动脉血氧饱和度/吸入气体氧含量(S/F)比值。联合检测LAR提高APACHEⅡ、SAPSⅡ、SOFA及S/F比值、P/F比值预测。单因素及多因素分析显示插管时长≤9 d、气管造瘘、氧合指数≤180 mmHg、28 d无机械通气时间<16 d及LAR>1.60是AHRF 60 d内死亡危险因素。多元COX比例风险回归模型分析显示LAR>1.60院内死亡风险上升。

结论

LAR是AHRF短期(60 d和院内)全因病死率的危险因素,为AHRF提供预后信息。

表1 急性低氧性呼吸衰竭ROC曲线分析
表2 多元COX比例风险回归模型分析
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