EVLWI、Ang-2在脓毒症合并ARDS预后评估中的价值

【】目的：探讨血管外肺水指数(EVLWI)、血管生成素-2(Ang-2)在脓毒症合并急性呼吸窘迫综合征(ARDS)患者预后评估中的价值。方法 选取2015年2月至2017年6月在我院治疗的脓毒症合并ARDS患者67例,根据住院期间是否死亡分为死亡组(n=31)和存活组(n=36),比较两组性别、年龄、呼气末正压通气(PEEP)、心输出指数(CI)、EVLWI、Ang-2等指标,采用受试者工作特征曲线(ROC)评估EVLWI、Ang-2预测预后的价值。结果 死亡组和存活组患者性别、年龄、PEEP、CI等指标比较差异无统计学意义(p＞0.05)；死亡组患者EVLWI和Ang-2分别为(14.13±5.21)ml/kg和(410.01±89.39)ng/L,明显高于存活组(p＜0.05)；EVLWI和Ang-2呈正相关(r=0.321,p＜0.05)；Logistic回归分析结果显示EVLWI和Ang-2是脓毒症合并ARDS患者死亡的危险因素(OR=2.499和1.589,p＜0.05)；EVLWI和Ang-2判断患者预后的ROC曲线下面积分别为0.834和0.745,p＜0.05,其中EVLWI截断值为12.91ml/kg时,灵敏度和特异度分别为61.30%和91.67%,Ang-2截断值为291.85ng/L时,灵敏度和特异度分别为58.02%和82.38%。结论 EVLWI、Ang-2在脓毒症合并ARDS预后评估中有一定的价值,且两者有一定的相关性。

The value of EVLWI and Ang-2 in evaluating prognosis of sepsis complicated with ARDS

Objective:To investigate the value of extravascular lung water index (EVLWI) and angiopoietin -2 (Ang-2) in the prognosis evaluation of sepsis complicated with acute respiratory distress syndrome (ARDS).Methods:67 patients with sepsis and ARDS were treated in our hospital from February 2015 to June 2017,patients were divided into the death group (n=31) and the survival group (n=36) according to whether they died during the hospital stay,the gender, age, end expiratory pressure (PEEP), cardiac output index (CI), EVLWI, Ang-2 and so on were compared between the two groups,the receiver operating characteristic curve (ROC) was used to assess the prognostic predictive value of EVLWI and Ang-2. Results:The gender, age, PEEP, CI and so on were not significantly different between the death group and the survival group (P > 0.05); EVLWI and Ang-2 in the death group were (14.13±5.21) ml/kg and (410.01±89.39) ng/L, which were significantly higher than those in the survival group (P < 0.05);There was a positive correlation between EVLWI and Ang-2 (r=0.321, P < 0.05); Logistic regression analysis showed that EVLWI and Ang-2 were the risk factors of mortality in patients with sepsis complicated with ARDS (OR=2.499 and 1.589, P < 0.05); The area of ROC curve of EVLWI and Ang-2 to judge the prognosis of patients were 0.834 and 0.745, P < 0.05, EVLWI cutoff value was 12.91 ml/kg, the sensitivity and specificity were 61.30% and 91.67%, Ang-2 cutoff value was 291.85 ng/L, the sensitivity and specificity were 58.02% and 82.38%.Conclusion:EVLWI and Ang-2 have some value in evaluating the prognosis of sepsis complicated with ARDS, and they are related.