PVPI联合血清CA125、IL-6对急性肺水肿患者预后的诊断价值

Prognostic value of PVPI combined with serum CA125 and IL-6 in patients with acute pulmonary edema

目的:探讨肺血管通透性指数(pulmonary vascular permeability index,PVPI)联合糖类抗原125 (carbohydrate antigen 125,CA125)、白细胞介素-6 (interleukin-6,IL-6)对急性肺水肿患者预后的预测价值。方法:选取2022年2月至2023年5月我院收治的急性肺水肿患者86例,入院后,均行机械通气治疗,根据28 d生存情况将患者存活组(n=63)和病死组(n=23),比较2组PVPI、CA125、IL-6及急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health status score systemⅡ,APACHEⅡ)、感染相关器官功能衰竭评分系统(infection-related organ failure score system,SOFA)及氧合指数(PaO_(2)/FiO_(2)),分析各指标水平变化与预后的相关性及对预后的影响。结果:入院3 d后,病死组PVPI、CA125、IL-6、APACHEⅡ、SOFA评分明显高于存活组,PaO_(2)/FiO_(2)低于存活组(P<0.05);PVPI、CA125、IL-6与PaO_(2)/FiO_(2)均呈负相关,与APACHEⅡ、SOFA评分呈正相关(P<0.01)。PVPI、CA125、IL-6单独预测急性肺水肿预后不良的AUC分别为0.728、0.712、0.761,截断值为3.20、58.87 U/ml、28.84 pg/ml;联合预测的AUC为0.834,敏感度为86.96%,特异度为87.30%,明显高于各指标单独预测(P<0.05)。PVPI、CA125、IL-6高值患者预后不良风险分别是低值患者的3.701、2.945、4.217倍(P<0.05)。结论:PVPI、CA125、IL-6与急性肺水肿患者预后明显相关,联合检测可作为预测急性肺水肿预后不良的重要辅助途径。

Objective:To investigate the prognostic value of pulmonary vascular permeability index(PVPI)combined with carbohydrate antigen 125(CA125)and interleukin-6(IL-6)in patients with acute pulmonary edema.Methods:A total of 86 patients with acute pulmonary edema admitted to our hospital from Feb 2022 to May 2023 were selected.After admission,all patients were treated with mechanical ventilation.According to their 28-day survival,they were divided into the survival group(n=63)and the death group(n=23).PVPI,CA125,IL-6,acute physiology and chronic health status score systemⅡ(APACHEⅡ),infection-related organ failure score system(SOFA)and oxygenation index(PaO_(2)/FiO_(2))were compared between the two groups,and the correlation between the level of each index and the prognosis and its effect on prognosis were analyzed.Results:Three days after admission,the scores of PVPI,CA125,IL-6,APACHEⅡand SOFA in the death group were significantly higher than those in the survival group,and the PaO_(2)/FiO_(2) was lower than that in the survival group(P<0.05).PVPI,CA125 and IL-6 were negatively correlated with PaO_(2)/FiO_(2),but positively correlated with APACHEⅡand SOFA scores(P<0.01).The AUC of PVPI,CA125,and IL-6 alone in predicting poor prognosis of acute pulmonary edema was 0.728,0.712,and 0.761,respectively,and the cut-off value was 3.20,58.87 U/ml,28.84 pg/ml.The AUC of combined prediction was 0.834,and the sensitivity was 86.96%,the specificity was 87.30%,which was significantly higher than that of each index alone(P<0.05).The risk of poor prognosis in patients with high PVPI,CA125,and IL-6 was 3.701,2.945 and 4.217 times that of patients with low PVPI,CA125,and IL-6,respectively(P<0.05).Conclusions:PVPI,CA125 and IL-6 are significantly correlated with the prognosis of patients with acute pulmonary edema.Combined detection can be used as an important auxiliary way to predict poor prognosis of patients with acute pulmonary edema.