摘要
目的:探讨急性呼吸窘迫综合征(ARDS)患者的氧合指数与SPO2/FiO2之间的关系。方法:回顾性采集模型组140例患者及验证组92例患者,对应地采集SPO2/FiO2(≤97%,PEEP≤5cmH2O)及PaO2/FiO2。两组患者分别采用相关检验中的spearman检验来了解SPO2/FiO2与PaO2/FiO2的相关性,采用linearregression求出其两者的线性方程,然后用受试者工作特征曲线(ROC)检验SPO2/FiO2对ARDS的诊断效能。结果:在模型组140例病例156对数据中,氧合指数与SPO2/FiO2的关系方程为SPO2/FiO2=73+0.946×OI[P<0.000;r=0.878]。当SPO2/FiO2=262mmHg相当于氧合指数=200mmHg,验证组92例病例118对数据中氧合指数与SPO2/FiO2亦存在相类似的线性关系,以SPO2/FiO2=262mmHg为判定阈值时,敏感性为90.12%,特异性为86.49%。使用ROC曲线对SPO2/FiO2对ARDS的诊断能力进行检验,模型组曲线下面积为0.876,验证组曲线下面积为0.941。结论:在ARDS患者病情监测中,SPO2/FiO2在一定程度可替代氧合指数。
Objective：To investigate the relation between oxygenation index and SPO2/ FiO2 in the patients with ARDS. Methods： Corresponding measurements of SPO2 and PaO2 from patients with ARDS trial of a lower tidal volume ventilator strategy （ n = 140 ） were compared to determine the relationship between S/F and P/F. S/F threshold values correlating with P/F ratios of 200 （ARDS） were determined. Similar measurements from patients enrolled in the trial of lower positive end - expiratory pressure （ n = 92 ） were utilized for validation. Receiver operator characteristic（ROC） curves were plotted to assess the degree of discrimination between S/F and P/F ratios. Results：in the derivation data set（ 156 measurements）, the relationship between S/F and P/F was described by the following equation： S/F = 73 ＋0.946×OI[P〈0.000;r=0.8781.An S/F ratio of 262 corresponded with a P/F ratio of 200, The validation database （ 118 measurements） produced a similar linear relationship. The S/F ratio threshold values of 262 resulted in 90.12% sensitivity with 86. 49% specificity for P/F ratios of 200. respectively,AUC for Derivation Data Set and Validation Data Set was（O. 876vs0. 941 ）. Conclusion：SPO2/FiO2 to a certain extent, can be used as an alternative data for the oxygenation index to diagnose ARDS.
