ROX指数预测流感相关肺炎患者气管插管的有效性分析

Effect of ROX Index in Predicting Tracheal Intubation in Patients with Influenza-related Pneumonia

目的探讨ROX指数预测流感相关肺炎患者气管插管的有效性。方法选取2018年12月1日-2020年2月15日苏州大学附属第一医院经鼻高流量氧疗治疗的流感相关肺炎患者47例作为研究对象,根据患者是否进行气管插管,将其分为未插管组30例和插管组17例。比较两组一般资料,并采用多因素Logistic回归分析气管插管的独立显著预测因子;采用受试者工作曲线(ROC)确定最佳的气管插管预测截断值。结果单因素分析显示,插管组与未插管组在BMI、甲型流感、淋巴细胞计数、白细胞计数、血小板计数、降钙素原、高血压史、糖尿病史、心率、PO2比较,差异无统计学意义(P>0.05);两组性别、年龄、APACHEⅡ评分、CRP、ROX指数比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,ROX指数是气管插管独立保护因素[β=-0.470,AOR(95%CI):0.630(0.400~0.980),P=0.041]。ROC曲线分析显示,ROX指数预测的曲线下面积为0.871(95%CI:0.765~0.976),最佳截断值为5.04,灵敏度为90.02%,特异度为70.62%。结论ROX指数对预测流感相关肺炎患者经鼻高流量氧疗中气管插管的准确性较高,有助于临床对该疾病的诊断。

Objective To investigate the effect of ROX index in predicting tracheal intubation in patients with influenza-associated pneumonia.Methods A total of 47 patients with influenza-associated pneumonia treated by nasal high flow oxygen therapy in the First Affiliated Hospital of Suzhou University from December 1,2018 to February 15,2020 were selected as the research objects.According to whether the patients were subjected to tracheal intubation,they were divided into the non-intubation group(n=30)and the intubation group(n=17).The general data were compared,and the independent predictors of tracheal intubation were analyzed by multivariate Logistic regression.The optimal cut-off value of tracheal intubation was determined by receiver operating curve(ROC).Results Univariate analysis showed that there was no significant difference in BMI,influenza A,lymphocyte count,white blood cell count,platelet count,procalcitonin,hypertension history,diabetes history,heart rate and PO2 between the intubation group and the non-intubation group(P>0.05);there were significant differences in gender,age,APACHEⅡ score,CRP and ROX index between the two groups(P<0.05).Multivariate logistic regression analysis showed that ROX index was an independent protective factor for tracheal intubation[β=-0.470,AOR(95%CI):0.630(0.400-0.980),P=0.041].ROC curve analysis showed that the area under the curve predicted by the ROX index was 0.871(95%CI:0.765-0.976),the optimal truncation value was 5.04,the sensitivity was 90.02%,and the specificity was 70.62%.Conclusion ROX index has high accuracy in predicting tracheal intubation in patients with influenza-associated pneumonia undergoing nasal high flow oxygen therapy,which is helpful for clinical diagnosis of the disease.