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中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (06) : 833 -836. doi: 10.3877/cma.j.issn.1674-6902.2023.06.019

临床研究

呼吸衰竭无创通气失败风险的RSBI预测分析
朱志伦, 王小忠()   
  1. 215026 苏州,苏州大学附属第二医院急重症医学科
  • 收稿日期:2023-09-05 出版日期:2023-12-25
  • 通信作者: 王小忠
  • 基金资助:
    江苏省卫生健康委科研课题(BJ209845)

RSBI prediction analysis of the risk of non­invasive ventilation failure in respiratory failure

Zhilun Zhu, Xiaozhong Wang()   

  • Received:2023-09-05 Published:2023-12-25
  • Corresponding author: Xiaozhong Wang
引用本文:

朱志伦, 王小忠. 呼吸衰竭无创通气失败风险的RSBI预测分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(06): 833-836.

Zhilun Zhu, Xiaozhong Wang. RSBI prediction analysis of the risk of non­invasive ventilation failure in respiratory failure[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(06): 833-836.

目的

分析浅快呼吸指数(rapid shallow breath index, RSBI)动态变化预测呼吸衰竭无创通气不佳的风险及临床意义。

方法

选取2021年4月至2023年1月我院收治的63例呼吸衰竭患者为对象,无创通气成功42例为对照组,通气不佳21例为观察组,收集临床资料、无创通气前、通气30 min后RSBI及通气前后RSBI差,采用多因素Logistic回归分析呼吸衰竭无创通气不佳的因素,构建预测模型,采用ROC曲线、决策曲线分析预测。

结果

观察组死亡8例(38.09%),对照组死亡6例(14.28%)(P<0.05);观察组心率(115.26±14.02)次/min,对照组心率(106.26±13.51)次/min,P<0.05;观察组pH (7.37±0.09),对照组pH (7.43±0.10)(P<0.05)。观察组无创通气RSBI值(106.26±14.55;91.21±10.22)高于对照组(85.59±16.59;57.23±9.16),通气RSBI差变化(17.34±3.69)低于对照组(27.95±5.47)(P<0.05);多因素Logistic回归分析显示年龄(OR=1.256)、通气前RSBI(OR=1.093)、30 min后RSBI(OR=1.140)及通气前后RSBI差(OR=0.715)是呼吸衰竭无创通气不佳的危险因素(P<0.05);ROC曲线显示年龄、通气前RSBI、30 min后RSBI、通气RSBI差等单项及联合指标预测模型对呼吸衰竭无创通气不佳发生风险具有统计学意义(P<0.05),联合预测模型AUC为0.975,敏感性97.14,特异性91.18,高于单项指标预测;决策曲线分析显示联合年龄和RSBI动态水平变化的呼吸衰竭无创通气不佳预测模型阈值概率5.32%~39.00%。

结论

RSBI动态水平变化可预测呼吸衰竭无创通气不佳风险,构建的无创通气不佳风险模型具有临床参考意义。

表1 两组患者一般资料结果(±s)
表2 两组患者RSBI动态变化比较(±s)
表3 呼吸衰竭无创通气Logistic回归分析
表4 呼吸衰竭患者预测模型的ROC结果比较
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