LUBS联合血乳酸对脓毒性休克患者病情及预后评估的价值

目的探讨肺部超声B线积分(LUBS)联合血乳酸对脓毒性休克患者病情及预后的评估价值。方法收集2019年2~12月重症医学科治疗的脓毒性休克患者病例,根据28d预后,分为存活组63例和死亡组33例,分析评价LUBS联合血乳酸对脓毒性休克患者死亡的风险预测价值。结果死亡组LUBS、血乳酸、急性生理与慢性健康评分表(APACHEⅡ)评分更高。LUBS、血乳酸两个指标均与APACHEⅡ评分呈正相关(r1=0.536,r2=0.714,P<0.01)。ROC生存曲线结果显示,LUBS、血乳酸、APACHEII评分、LUBS联合血乳酸预测脓毒性休克患者死亡的曲线下面积(AUC)分别为0.847、0.842、0.75、0.951,LUBS联合血乳酸预测脓毒性休克患者死亡的AUC明显高于其他单一指标,与APACHEⅡ评分相比,差异有统计学意义(Z=3.18,P<0.01),其敏感度为84.6%,特异度为95.2%。LUBS与血乳酸两者联合均较其他单独评价指标具有更好的预后评估价值。结论LUBS与血乳酸有助于评估脓毒性休克患者的病情严重程度,两者联合对28d预后评估效果更好。

Objective To investigate the value of lung ultrasonic B-line score(LUBS)combined with blood lactate in prognostic evaluation of septic shock.Methods The cases of septic shock patients treated in the Department of Critical Care Medicine from February to December 2019 were collected.According to the 28-day prognosis,they were divided into 63 cases in the survival group and 33 cases in the death group,and the value of LUBS combined with blood lactate were analyzed and evaluated in predicting the risk of death in patients with septic shock.Results The LUBS,blood lactate,APACHE Ⅱ scores were higher in the death group.Both LUBS and blood lactic acid were positively correlated with APACHE II score(r1=0.536,r2=0.714,P<0.01).ROC survival curve results showed that the area under the curve(AUC)of LUBS,blood lactate,APACHE Ⅱ score,LUBS combined with blood lactate to predict the death of patients with septic shock were 0.847,0.842,0.75,0.951.The AUC of death was significantly higher than other single indicators.Compared with the APACHE Ⅱ score,the difference was statistically significant(Z=3.18,P<0.01),the sensitivity was 84.6%,and the specificity was 95.2%.The combination of LUBS and blood lactate had better prognostic evaluation value than other independent evaluation indicators.Conclusion LUBS and blood lactate help to assess the severity of the condition of patients with septic shock,and the combination of the two has a better prognosis assessment effect on 28 days.