复合指数A-aDO_(2)、a/A比值与PaO_(2)/FiO_(2)预测晚期早产儿呼吸窘迫伴呼吸衰竭的价值研究

The Value of Composite Index A-aDO_(2),a/A Ratio and PaO_(2)/FiO_(2)in Predicting Respiratory Distress with Respiratory Failure in Late Preterm Infants

目的探讨复合指数肺泡动脉氧分压差(A-aDO_(2))、动脉肺泡氧分压(a/A)比值与氧合指数(PaO_(2)/FiO_(2))预测晚期早产儿呼吸窘迫伴呼吸衰竭的价值研究。方法按照简单随机数字表法选取呼吸窘迫症晚期早产儿,40例不需要机械通气为对照组,40例需要机械通气为观察组。分析呼吸衰竭参数对晚期早产儿呼吸窘迫需要机械通气的预测、复合指数A-aDO_(2)、a/A比值与PaO_(2)/FiO_(2)差异比较、预测参数的敏感度、特异度、阳性预测值、阴性预测值、阳性率、阴性率、约登指数并制作出ROC曲线。结果两组患儿最大A-aDO_(2)、最低a/A比值、最低PaO_(2)/FiO_(2)的AUC曲线差异无统计学意义(P>0.05)。这3个AUC曲线均比PaCO_(2)的AUC曲线高,A-aDO_(2)曲线超过最大FiO_(2)曲线(P<0.05)。A-aDO_(2)>200mmHg被证明为预测呼吸衰竭最有效的指数,观察组患儿均达到A-aDO_(2)>200mmHg的标准。结论复合指数A-aDO_(2)、a/A比值与PaO_(2)/FiO_(2)能够对晚期早产儿呼吸窘迫伴呼吸衰竭进行合理预测,且预测效果明显,具有一定的研究价值。

Objective To investigate the predictive value of composite index alveolar arterial oxygen difference(A-aDO_(2)),arterial alveolar oxygen partial pressure ratio(a/A)ratio and oxygenation index(PaO_(2)/FiO_(2))in predicting respiratory distress with respiratory failure in late preterm infants value research.Methods According to the simple random number table method,80 cases of late preterm infants with respiratory distress syndrome were selected,40 cases did not require mechanical ventilation as the control group,and 40 cases required mechanical ventilation as the observation group.To analyze the prediction of respiratory failure parameters on the need for mechanical ventilation in late preterm infants with respiratory distress,the composite index A-aDO_(2),the difference between a/A ratio and PaO_(2)/FiO_(2),the sensitivity,specificity,positive predictive value,negative predictive value,Positive rate,negative rate,Youden index and make ROC curve.Results There were no differences in the AUC curves of the maximum A-aDO_(2),the minimum a/A ratio,and the minimum PaO_(2)/FiO_(2)between the two groups(P>0.05).The three AUC curves were higher than that of PaCO_(2),and the A-aDO_(2)curve exceeded the maximum FiO_(2)curve(P<0.05).A-aDO_(2)>200 mmHg was proved to be the most effective index for predicting respiratory failure,and all children in the observation group reached the standard of A-aDO_(2)>200 mmHg.Conclusion The composite index A-aDO_(2),a/A ratio and PaO_(2)/FiO_(2)can reasonably predict respiratory distress with respiratory failure in late preterm infants,and the prediction effect is obvious,which has a certain research value.