机械功监测结合血清IL-6水平对急性呼吸窘迫综合征患者肺复张潜能的评估价值

Evaluation Value of Mechanical Work Monitoring Combined with Serum IL-6 Level in Lung Recruitment Potential in Patients with Acute Respiratory Distress Syndrome

目的:分析机械功监测结合血清白细胞介素-6(IL-6)水平对急性呼吸窘迫综合征患者肺复张潜能的评估价值。方法:回顾性分析2019年12月—2022年12月于如皋市中医院重症医学科住院的50例急性呼吸窘迫综合征患者,同时招募52例于本院体检健康人士,分别记为观察组与参照组。比较两组IL-6水平,采用多因素分析影响急性呼吸窘迫综合征患者肺复张潜能的影响因素,以受试者操作特征(ROC)曲线评价机械功监测结合血清IL-6对急性呼吸窘迫综合征患者肺复张潜能的评估价值。结果:观察组IL-6水平高于参照组,差异有统计学意义(P<0.05)。观察组发生肺复张潜能为8例,占比16.00%,未发生肺复张潜能为42例,占比84.00%。发生肺复张潜能与未发生肺复张潜能患者年龄、体重指数(BMI)、性别、吸烟、饮酒、急性呼吸窘迫综合征类型、白细胞计数、心脏指数、平均动脉压、氧合指数比较,差异均无统计学意义(P>0.05)。发生肺复张潜能患者IL-6水平高于未发生肺复张潜能患者,差异有统计学意义(P<0.05)。发生肺复张潜能患者机械功高于未发生肺复张潜能患者(P<0.05)。机械功监测、IL-6水平是患者发生肺复张潜能的危险因素(P<0.05)。机械功监测、IL-6联合评估急性呼吸窘迫综合征患者肺复张潜能效果最佳,其曲线下面积(AUC)为0.936,高于单独评估的0.779、0.790,敏感度与特异度分别为90.50%,84.80%。结论:机械功监测结合血清IL-6水平对急性呼吸窘迫综合征患者肺复张潜能的评估价值较高。

Objective:To analyze the evaluation value of mechanical work monitoring combined with serum interleukin-6(IL-6)level in lung recruitment potential in patients with acute respiratory distress syndrome.Method:A retrospective analysis of 50 patients with acute respiratory distress syndrome who were hospitalized in the Intensive Care Department of Rugao Hospital of Traditional Chinese Medicine from December 2019 to December 2022,and 52 healthy persons who underwent physical examination in our Hospital were recruited,and recorded as observation group and reference group respectively.IL-6 levels were compared between the two groups,and the influencing factors affecting lung recruitment potential in patients with acute respiratory distress syndrome were analyzed by multivariate analysis,the evaluation value of mechanical work monitoring combined with serum IL-6 on lung recruitment potential in patients with acute respiratory distress syndrome was evaluated by receiver operating characteristic(ROC)curve.Result:IL-6 level in the observation group was higher than that in the reference group,the difference was statistically significant(P<0.05).In the observation group,8 patients developed lung recruitment potential,accounting for 16.00%,while 42 patients did not develop lung recruitment potential,accounting for 84.00%.There were not significant differences in age,body mass index(BMI),gender,smoking,drinking,type of acute respiratory distress syndrome,white blood cell count,cardiac index,mean arterial pressure and oxygenation index between patients with and without pulmonary recruitment potential(P>0.05).The level of IL-6 in patients with pulmonary recruitment potential was higher than that in patients without pulmonary recruitment potential,the difference was statistically significant(P<0.05).The mechanical work in patients with pulmonary recruitment potential was higher than that patients without lung recruitment potential(P<0.05).Mechanical work monitoring and IL-6 levels are risk factors for the development of lung atelectasis potential in patients(P<0.05).The combination of mechanical work monitoring and IL-6 had the best effect in evaluating the lung recruitment potential of patients with acute respiratory distress syndrome,and the area under curve(AUC)was 0.936,higher than separately evaluated values of 0.779 and 0.790 respectively,sensitivity and specificity were 90.50%and 84.80%.Conclusion:Mechanical work monitoring combined with serum IL-6 level is of high value in evaluating lung recruitment potential in patients with acute respiratory distress syndrome.