LUS评分联合外周血PCT、CRP及IL-6水平评估ARDS患者病情严重程度及预后的价值
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四川省自然科学基金项目(2024NSFSC0488);


Value of lung ultrasound score combined with peripheral blood procalci-tonin,C-reactive protein and interleukin-6 levels on evaluating the disease severity and prognosis of patients with acute respiratory distress syn-drome
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    摘要:

    目的:探讨肺部超声(LUS)评分联合外周血降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素6(IL-6)水平用于评估急性呼吸窘迫综合征(ARDS)患者病情严重程度及预后的价值。方法:选取109例ARDS患者为研究对象,依据病情严重程度分为轻度组(n=24)、中度组(n=55)和重度组(n=30);依据预后结果分为存活组(n=68)和死亡组(n=41)。比较不同病情严重程度患者的一般资料、不同病情严重程度和不同预后患者LUS评分、外周血PCT、CRP及IL-6水平,分析上述指标对病情严重程度及预后的评估价值。结果:不同病情严重程度患者预后结果及APACHEⅡ评分比较,差异均有统计学意义(P<0.05),各组患者存活率比较:重度组<中度组<轻度组(P<0.05);各组患者APACHEⅡ评分比较:重度组>中度组>轻度组(P<0.05)。不同病情严重程度的ARDS患者LUS评分及外周血PCT、CRP及IL-6水平比较,差异有统计学意义(P<0.05),且重度组>中度组>轻度组。Spearman相关性分析显示,ARDS患者LUS评分及外周血PCT、CRP及IL-6水平均与疾病严重程度呈正相关关系(P<0.05)。死亡组LUS评分、PCT、CRP、IL-6水平均高于存活组(P<0.05)。Logistic回归分析显示,APACHEⅡ评分、LUS评分、PCT、CRP、IL-6、病情严重程度是ARDS患者预后的影响因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,LUS评分及外周血PCT、CRP及IL-6水平及联合检测对ARDS患者死亡预后预测的曲线下面积(AUC)分别为0.778、0.781、0.864、0.856、0.982;敏感度分别75.61%、78.05%、90.24%、80.49%、92.68%,其中联合检测的预测价值更高。结论:LUS评分及外周血PCT、CRP、IL-6水平检测可有效评估ARDS患者的病情严重程度,并对患者预后有预测价值。

    Abstract:

    Objective:To explore the value of lung ultrasound(LUS)score combined with peripheral blood procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)levels on evaluation of disease severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods:109 patients with ARDS were selected.The disease severity and progno-sis of patients were grouped according to the Berlin criteria for ARDS.The baseline data were compared among mild group(n=24),moderate group(n=55)and severe group(n=30).According to the prognosis,they were divided into a survival group(n=68)and a death group(n=41).The differences in LUS score,peripheral blood PCT,CRP and IL-6 levels among the three groups and patients with different prognoses were analyzed,and the evaluation value of the above indexes on the disease severity and prognosis was analyzed.Results:There were statistical differences in prognosis and APACHE Ⅱ score among the three groups(P<0.05).The survival rate of patients in severe group was lower than that in moderate group(P<0.05),and the rate in moderate group was lower than that in mild group(P<0.05).The APACHE Ⅱ score of patients in severe group was higher than that in moderate group(P<0.05),and the score in moderate group was higher than that in mild group(P<0.05).The LUS score and peripheral blood PCT,CRP and IL-6 levels revealed statistical differences among ARDS patients with different disease severities(P<0.05).The severe group was higher than the moderate group(P<0.05),and the moder-ate group was higher than the mild group(P<0.05).Spearman analysis showed that LUS score and peripheral blood PCT,CRP and IL-6 in ARDS patients were positively correlated with disease severity(P<0.05).The LUS score,PCT,CRP and IL-6 in death group were higher than those in survival group(P<0.05).After Logistic regression analysis,it was found that A-PACHE Ⅱ score,LUS score,PCT,CRP,IL-6 and disease severity were the influencing factors of prognosis in patients with ARDS(P<0.05).ROC curve results showed that the areas under the ROC curves of LUS score,peripheral blood PCT,CRP and IL-6 and combined detection for predicting the death prognosis in ARDS patients were 0.778,0.781,0.864,0.856 and 0.982,and the sensitivities were 75.61%,78.05%,90.24%,80.49%and 92.68%,respectively.The combined detection value was higher.Conclusion:LUS score and peripheral blood PCT,CRP and IL-6 levels can effectively evaluate the disease severity of ARDS patients,and have reliable predictive value for prognosis of patients.

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王熙宇;廖芮;王中;. LUS评分联合外周血PCT、CRP及IL-6水平评估ARDS患者病情严重程度及预后的价值[J].川北医学院学报,2025,40(10):1244-1248.

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  • 在线发布日期: 2025-11-03
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