|本期目录/Table of Contents|

[1]程玲燕,卢嘉宾,韦 庆,等.急性低氧性呼吸衰竭乳酸/白蛋白比值与病死率相关性分析[J].中华肺部疾病杂志,2023,(05):654-657.[doi:10.3877/cma.j.issn.1674-6902.2023.05.010]
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急性低氧性呼吸衰竭乳酸/白蛋白比值与病死率相关性分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2023年05期
页码:
654-657
栏目:
临床研究
出版日期:
2023-10-20

文章信息/Info

Title:
-
作者:
程玲燕; 卢嘉宾; 韦 庆; 兰 祖
547000 河池,河池市人民医院·右江民族医学院附属河池医院呼吸与危重症医学科
Author(s):
-
关键词:
急性低氧性呼吸衰竭;  血乳酸;  白蛋白;  预后
Keywords:
-
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2023.05.010
摘要:
目的 分析乳酸/白蛋白比值(LAR)与急性低氧性呼吸衰竭(AHRF)病死率的相关性。方法 选择2019年4月至2022年12月我院收治的AHRF患者39例为对象,主要结局随访60 d内全因病死率,分为预后不良14例及预后良好25例; 次要结局院内病死率。检测动脉血乳酸水平,血清白蛋白水平,计算LAR。结果 预后不良者LAR高[2.00(1.07,3.02)vs. 1.03(0.68,1.97),Z=-2.753,P=0.006]。ROC曲线分析显示LAR对AHRF 60 d内预测曲线下面积(AUC)0.873[95%置信区间:0.796～0.950]高于急性生理与慢性健康评分Ⅱ(APACHEⅡ)、简化急性生理学评分Ⅱ(SAPSⅡ)、序贯器官衰竭(SOFA)及动脉血氧分压/吸入气体氧含量(P/F)比值、动脉血氧饱和度/吸入气体氧含量(S/F)比值。联合检测LAR提高APACHEⅡ、SAPSⅡ、SOFA及S/F比值、P/F比值预测。单因素及多因素分析显示插管时长≤9 d、气管造瘘、氧合指数≤180 mmHg、28 d无机械通气时间<16 d及LAR>1.60是AHRF 60 d内死亡危险因素。多元COX比例风险回归模型分析显示LAR>1.60院内死亡风险上升。结论 LAR是AHRF短期(60 d和院内)全因病死率的危险因素,为AHRF提供预后信息。
Abstract:
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参考文献/References:

1 Tan W, Xu DY, Xu MJ, et al. The efficacy and tolerance of prone positioning in non-intubation patients with acute hypoxemic respiratory failure and ARDS: a meta-analysis[J]. Ther Adv Respir Dis, 2021, 15: 17534666211009407.
2 任成山, 钱桂生. 呼吸衰竭的临床诊断与治疗[J/CD]. 中华肺部疾病杂志(电子版), 2011, 4(1): 63-76.
3 Mauri T, Foti G, Fornari C, et al. Sigh in patients with acute hypoxemic respiratory failure and ARDS: The PROTECTION pilot randomized clinical trial[J]. Chest, 2021, 159(4): 1426-1436.
4 Fukuda Y, Tanaka A, Homma T, et al. Utility of SpO2/FiO2 ratio for acute hypoxemic respiratory failure with bilateral opacities in the ICU[J]. PLoS One, 2021, 16(1): e0245927.
5 Lu Y, Guo H, Chen X, et al. Association between lactate/albumin ratio and all-cause mortality in patients with acute respiratory failure: A retrospective analysis[J]. PLoS One, 2021, 16(8): e0255744.
6 王 景, 朱述阳, 朱洁晨, 等. 血清超敏C反应蛋白/白蛋白比值预测慢性阻塞性肺疾病急性加重合并呼吸衰竭患者早期再入院的临床价值[J]. 科学技术与工程, 2019, 19(17): 128-132.
7 Gharipour A, Razavi R, Gharipour M, et al. Lactate/albumin ratio: An early prognostic marker in critically ill patients[J]. Am J Emerg Med, 2020, 38(10): 2088-2095.
8 Shadvar K, Nader-Djalal N, Vahed N, et al. Comparison of lactate/albumin ratio to lactate and lactate clearance for predicting outcomes in patients with septic shock admitted to intensive care unit: an observational study[J]. Sci Rep, 2022, 12(1): 13047.
9 Liu Q, Zheng HL, Wu MM, et al. Association between lactate-to-albumin ratio and 28-days all-cause mortality in patients with acute pancreatitis: A retrospective analysis of the MIMIC-Ⅳ database[J]. Front Immunol, 2022, 13: 1076121.
10 Zhu JL, Liu H, Wang LL, et al. Association of lactate to albumin ratio and bicarbonate with short-term mortality risk in patients with acute myocardial infarction[J]. BMC Cardiovasc Disord, 2022, 22(1): 490.
11 任秋艳, 姚惠萍, 罗月月, 等. 不同温度设置对经鼻高流量氧疗急性呼吸衰竭患者的影响[J]. 中华现代护理杂志, 2021, 27(26): 3609-3612.
12 Chalmers SJ, Odeyemi YE, Lal A, et al. F Trajectory as a pragmatic intermediate marker in acute hypoxic respiratory failure[J]. Respir Care, 2021, 66(10): 1521-1530.
13 Kopczynska M, Sharif B, Pugh R, et al. Prevalence and outcomes of acute hypoxaemic respiratory failure in Wales: The PANDORA-WALES study[J]. J Clin Med, 2020, 9(11): 3521-3533.
14 McNamee JJ, Gillies MA, Barrett NA, et al. Effect of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal vs standard care ventilation on 90-day mortality in patients with acute hypoxemic respiratory failure: The REST randomized clinical trial[J]. JAMA, 2021, 326(11): 1013-1023.
15 Pelosi P, Ball L, Barbas CSV, et al. Personalized mechanical ventilation in acute respiratory distress syndrome[J]. Crit Care, 2021, 25(1): 250-259.
16 Alladina J, Levy SD, Cho JL, et al. Plasma soluble suppression of tumorigenicity-2 associates with ventilator liberation in acute hypoxemic respiratory failure[J]. Am J Respir Crit Care Med, 2021, 203(10): 1257-1265.
17 郭 喆, 柴 彦, 方奕鹏, 等. 不同氧合评估法对急性呼吸窘迫综合征的预后评价[J]. 中国急救医学, 2021, 41(11): 966-971.
18 Huber W, Findeisen M, Lahmer T, et al. Prediction of outcome in patients with ARDS: A prospective cohort study comparing ARDS-definitions and other ARDS-associated parameters, ratios and scores at intubation and over time[J]. PLoS One, 2020, 15(5): e0232720.
19 Kao KC, Chang KW, Chan MC, et al. Predictors of survival in patients with influenza pneumonia-related severe acute respiratory distress syndrome treated with prone positioning[J]. Annals of Intensive Care, 2018, 8: 94-102.
20 Prakash J, Bhattacharya PK, Yadav AK, et al. ROX index as a good predictor of high flow nasal cannula failure in COVID-19 patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis[J]. J Crit Care, 2021, 66:102-108.
21 TalpoS MT, Rasson A, De Terwangne C, et al. Early prediction of high-flow oxygen therapy failure in COVID-19 acute hypoxemic respiratory failure: A retrospective study of scores and thresholds[J]. Cureus, 2022, 14(11): e32087.
22 Carvalho EB, Leite TRS, Sacramento RFM, et al. Rationale and limitations of the SpO2/FiO2 as a possible substitute for PaO2/FiO2 in different preclinical and clinical scenarios[J]. Rev Bras Ter Intensiva, 2022, 34(1): 185-196.
23 Wang G, Liu J, Xu R, et al. Lactate/albumin ratio as a predictor of in-hospital mortality in critically ill children[J]. BMC Pediatr, 2022, 22(1): 725-735.
24 Song H, Moon HG, Kim SH. Efficacy of quick sequential organ failure assessment with lactate concentration for predicting mortality in patients with community-acquired pneumonia in the emergency department[J]. Clin Exp Emerg Med, 2019, 6(1): 1-8.
25 牟厚玲, 韩 平. APACHEⅡ评分及血乳酸清除率在呼吸衰竭患者病情及预后评估的研究[J]. 中国实验诊断学, 2020, 24(2): 230-233.
26 Deng XJ, Zou Y, Wu J, et al. The effect of blood lactate and NT-proBNP predict the survival in patients with invasive mechanical ventilation[J]. Ann Transl Med, 2020, 8(7): 458.
27 李若青, 田继刚, 杨 芳, 等. 2019-新型冠状病毒感染的肺炎患者血清白蛋白浓度与淋巴细胞水平关系的临床研究[J]. 中华急诊医学杂志, 2020, 29(4): 478-482.
28 黄琪惠, 张 琳. 中性粒细胞/淋巴细胞比值、C-反应蛋白/白蛋白及低钙在重症颅脑损伤并早期呼吸机相关性肺炎的价值分析[J]. 实用医学杂志, 2021, 37(7): 903-908.
29 Shi T, Feng L. Blood biomarkers associated with acute type Ⅱ respiratory failure in COPD: A meta-analysis[J]. Clin Respir J, 2022, 16(2): 75-83.
30 Jeong JH, Heo M, Lee SJ, et al. Clinical usefulness of red cell distribution width/albumin ratio to discriminate 28-day mortality in critically Ⅲ patients with pneumonia receiving invasive mechanical ventilation, compared with lacate/albumin ratio: A retrospective cohort study[J]. Diagnostics(Basel), 2021, 11(12): 2344.

备注/Memo

备注/Memo:
基金项目: 河池市科技计划项目(河科AB193607)
通信作者: 兰 祖, Email: lanzu2023@126.com
更新日期/Last Update: 2023-10-20