自身血容量/预充量比值对婴幼儿体外循环后毛细血管渗漏综合征的预测意义

Predict significance of the auto-blood volume/prime volume ratio on capillary leak syndrome after cardiopulmonary bypass in infants

目的探讨自身血容量/预充量比值(A/P)对低体重婴幼儿体外循环(CPB)后毛细血管渗漏综合征(CLS)的预测作用。方法回顾分析了204例体重≤13 kg的行CPB心脏手术患儿的临床资料,通过受试者工作曲线(ROC)分析A/P比值预测术后CLS发生最佳临界值,并据此对2012年1月~2012年12月期间行CPB心脏手术的先天性心脏病患儿进行前瞻性队列研究,比较A/P比值对CLS发生的影响。结果 204例病例对照研究的患儿CPB术后CLS发生26例,发病率为12.75%,ROC曲线下面积0.757,根据ROC曲线选定1.285为最佳临界值。据此,将161名队列研究病例分为≤1.285组和>1.285组,两组CLS的发病率分别为14.10%、2.41%,相对危险度(RR)为5.85。结论 A/P比值对低体重婴幼儿CPB术后CLS的发生有较强的预测意义,A/P比值≤1.285的患儿CPB心脏手术后易发生CLS。

Objective To evaluate the predict significance of the auto-blood volume/prime volume(A/P) ratio on capillary leak syndrome(CLS) after cardiopulmonary bypass(CPB) in low-weight infants.Methods Clinical data was retrospectively collect-ed and analyzed from infants(weight≤13 kg) underwent CPB in our hospital between October 2008 and February 2010.Receiver oper-ating characteristic curve(ROC) was used to estimate optimal operating point(OOP).Then prospective cohort study was performed on clinical data from January 2012 to December 2012 to evaluate the effect of A/P ratio on morbidity of CLS.Results The morbidity of CLS in retrospective clinical data was 12.75%.Area under the curve of ROC was 0.757.Meanwhile,1.285 was selected as OOP based on ROC.161 infants underwent CPB were enrolled in prospective cohort study which were divided into A/P ratio ≤1.285 and>1.285 groups based on OOP.The morbidities of the two groups were 14.10% and 2.41% respectively.Furthermore,the relative risk(RR) was 5.85.Conclusion A/P ratio on the predict significance of CLS after CPB is powerful.The morbidity of CLS after CPB is higher when A/P ratio is less than 1.285.