SpO_(2)/FiO_(2)预测ARDS患者临床结局的价值

Application of SpO_(2)/FiO_(2)in predicting the clinical outcome of patients with ARDS

目的探讨脉搏血氧饱和度/吸入氧浓度(SpO_(2)/FiO_(2))是否可以作为预测急性呼吸窘迫综合征(ARDS)患者临床结局可靠的无创检测指标。方法本研究为回顾性研究,共纳入2016年1月至2019年12月入住我院呼吸与危重症医学科的221例ARDS患者,收集其入院后24 h内的SpO_(2)、动脉血氧分压(PaO_(2))、pH值、FiO_(2)和急性生理学与慢性健康状况(APACHEⅡ)评分。采用线性回归方法分析SpO_(2)/FiO_(2)与PaO_(2)/FiO_(2)的关系。绘制受试者工作特征曲线(ROC),比较SpO_(2)/FiO_(2)、PaO_(2)/FiO_(2)和APACHEⅡ评分ROC的曲线下面积(AUC)。结果PaO_(2)/FiO_(2)和SpO_(2)/FiO_(2)呈高度相关(R2=0.641,P<0.001)。PaO_(2)/FiO_(2)、SpO_(2)/FiO_(2)、APACHEⅡ评分预测ARDS患者院内病死率的AUC分别为0.586(95%CI:0.498~0.674,P=0.051),0.644(95%CI:0.503~0.681,P<0.05),0.782(95%CI:0.717~0.846,P<0.05)。结论SpO_(2)/FiO_(2)可替代PaO_(2)/FiO_(2)作为预测ARDS患者临床结局可靠的无创指标。

Objective To explore whether SpO_(2)/FiO_(2)can be used as a reliable noninvasive testing indicators for predicting clinical outcome in patients with ARDS.Methods This was a retrospective study of 221 ARDS patients enrolled in the Department of Respiratory Critical Care of our hospital from January 2016 to December 2019.SpO_(2),PaO_(2),pH,FiO_(2)and APACHEⅡscore within 24 hours of admission were collected.The relationship between SpO_(2)/FiO_(2)and PaO_(2)/FiO_(2)was analyzed by using linear regression methods.Receiver operator characteristic curve(ROC)were plotted to compare the area under the SpO_(2)/FiO_(2),PaO_(2)/FiO_(2)and APACHEⅡscore ROC curves(AUC).Results PaO_(2)/FiO_(2)and SpO_(2)/FiO_(2)were highly correlated(R2=0.641,P<0.001),AUC of PaO_(2)/FiO_(2),SpO_(2)/FiO_(2),APACHEⅡscore that predicted hospital mortality in patients with ARDS was 0.586(95%CI:0.498-0.674,P=0.051),0.644(95%CI:0.503-0.681,P<0.05),0.782(95%CI:0.717-0.846,P<0.05),respectively.Conclusion SpO_(2)/FiO_(2)can be a substitute for PaO_(2)/FiO_(2)as a reliable noninvasive indicator for predicting clinical outcome in ARDS patients.