SPO_2/FiO_2替代氧合指数评价中重度ARDS的研究

Comparison of the SPO_2/FiO_2 and PaO_2/FiO_2 as an Evaluation of the Severity for Patients with Moderately or Severe ARDS

目的探讨SpO2/FiO2替代氧合指数作为评价ARDS金标准指标的可行性及其之间的量化关系。方法随机抽取笔者所在科室(急诊科)符合中重度诊断标准的ARDS病员共72名,按照7∶3比例随机分为模型组和验证组,均予监护、吸氧、抽动脉血气分析、记录SpO2,及吸氧流量等措施,根据如上指标分别计算P/F及S/F。结果模型组(n=49):Y(S/F)=74.609(b)+0.522(a)X(P/F),P<0.001。r=0.625,P<0.001;与P/F=100对应的S/F值为126.8,敏感度和特异性分别为78.3%和52.2%,ROC曲线下的面积为0.578。结论对于中重度ARDS患者,S/F基本可以替代P/F评价疾病的严重程度并指导临床诊断治疗。

Objective To evaluate the quantitative relationship and feasibility of the SpOJFiO2 alternative oxygenation index as e- valuation of ARDS. Methods Seventy - two patients were conformed the diagnostic criteria of moderately or severe ARDS patients, ac- cording to the proportion （70% ： 30% ） , and were randomly divided into derivation group and validation group. These two groups were both given the guardianship, oxygen, arterial blood gas analysis, SpO2 , and oxygen flow rate. P/F and S/F were calculated respectively according to the above indicators. Results In the derivation group, the relationship between S/F and P/F was described by the equation： Y（S/F） =74. 609（b） ＋ 0.522（a） X（P/F） ,P 〈0.001, n =49 and r =0.625,P 〈0.001. When the value of P/F was 100, the value of S/F was corresponding to 126.8. The value of S/F was 78.3% for sensitivity and 52.2% for specificity. Area was 0. 578 in the ROC curve. Conclusion For patients with moderately or severe ARDS, S/F can replace P/F as an evaluation of the severity of the disease and guide the clinical diagnosis and treatment.