急性主动脉夹层并发急性肺损伤的危险因素分析及预测评分表的建立
发布时间：2018-11-17 18:39
【摘要】：目的:通过对急性主动脉夹层(AAD)并发急性肺损伤(ALI)的危险因素分析,建立AAD并发ALI的预测评分表。方法:回顾性分析新疆医科大学第一附属医院心脏中心2014年1月至2015年12月连续收治的143例AAD患者的临床资料,按是否发生ALI分为ALI组和非ALI组,对可能的危险因素进行单因素分析,将有统计学差异的相关因素,通过绘制受试者工作特征曲线(ROC曲线),分析其对ALI发生的最佳临界值和预测价值,并根据最佳临界值将相关的连续性变量转化为二分类变量,进行多因素Logistic回归分析,根据各个危险因素的OR值大小,对独立危险因素赋分,建立预测评分表。结果:(1)AAD并发ALI的发生率约为44.76%。(2)ALI组的BMI、入院时WBC及入院时CRP较非ALI组均偏高,在两组间差异均有统计学意义(P0.05)。ALI组与非ALI组相比,ALI组患者入院时易伴有胸腔积液,在两组间差异有统计学意义(P0.05)。(3)通过绘制ROC曲线,BMI预测AAD并发ALI的最佳临界值为25.65kg/m2(敏感度为87.5%,特异度为40.5%),WBC预测AAD并发ALI的最佳临界值为15.00×109/L(敏感度为59.4%,特异度为81.0%),CRP预测AAD并发ALI的最佳临界值为15.81mg/L(敏感度为51.6%,特异度为75.6%)。入院时伴有胸腔积液预测AAD并发ALI的敏感度为57.8%,特异度为65.8%。(4)两组患者经多因素Logistic回归分析发现,WBC≥15.00×109/L(OR=7.143,95%CI 2.972-17.169)、CRP≥15.81mg/L(OR=2.696,95%CI 1.156-6.284)、BMI≥25.65 kg/m2(OR=5.892,95%CI 2.117-16.396)及胸腔积液(OR=4.365,95%CI 1.849-10.300)是AAD并发ALI的独立危险因素。(5)AAD患者按照独立危险因素在预测评分表中分值高低可分为三组:低危组(分值0-3)、中危组(分值4-6)和高危组(分值7-9),低危组ALI发生率约为12.5%,中危组ALI发生率约为53.7%,高危组ALI发生率约为84.8%。结论:通过对AAD并发ALI的危险因素分析,BMI≥25.65kg/m2、入院时WBC≥15.00×109/L、入院时CRP≥15.81mg/L及入院时伴有胸腔积液是AAD并发ALI的独立危险因素。AAD并发ALI的预测评分表可预见性地评估AAD患者发生ALI的风险,有助于对AAD患者进行分层管理。
[Abstract]:Objective: to study the risk factors of acute aortic dissection (AAD) complicated with acute lung injury (ALI) and to establish a predictive scale for AAD complicated with ALI. Methods: the clinical data of 143 consecutive patients with AAD admitted to the Cardiac Center of the first affiliated Hospital of Xinjiang Medical University from January 2014 to December 2015 were retrospectively analyzed. According to the occurrence of ALI, they were divided into ALI group and non-ALI group. By univariate analysis of possible risk factors and correlation factors with statistical differences, the optimal critical value and predictive value of ALI were analyzed by drawing the operating characteristic curve (ROC curve) of the subjects. According to the optimal critical value, the related continuous variables are transformed into two classification variables, and the multivariate Logistic regression analysis is carried out. According to the OR value of each risk factor, the independent risk factors are assigned a score, and the prediction score table is established. Results: (1) the incidence of AAD complicated with ALI was about 44.76. (2) the WBC and CRP of BMI, in ALI group were higher than those in non-ALI group at admission, and there was significant difference between the two groups (P0.05 between). ALI group and non-ALI group). The patients in ALI group were more likely to be accompanied with pleural effusion on admission. The difference between the two groups was statistically significant (P0.05). (3). By drawing the ROC curve, the best critical value of BMI for predicting AAD complicated with ALI was 25.65kg/m2 (sensitivity was 87.5%). The best critical value for predicting AAD complicated with ALI with 40.5%), WBC was 15.00 脳 10 ~ 9 / L (sensitivity was 59.4%, specificity was 81.0%). The best critical value for AAD complicated with ALI by CRP was 15.81mg/L (sensitivity was 51.6%, specificity was 75.6%). At admission, the sensitivity and specificity of AAD complicated with ALI were 57.8 and 65.8 respectively. (4) by multivariate Logistic regression analysis, WBC 鈮，
本文编号：2338715
[Abstract]:Objective: to study the risk factors of acute aortic dissection (AAD) complicated with acute lung injury (ALI) and to establish a predictive scale for AAD complicated with ALI. Methods: the clinical data of 143 consecutive patients with AAD admitted to the Cardiac Center of the first affiliated Hospital of Xinjiang Medical University from January 2014 to December 2015 were retrospectively analyzed. According to the occurrence of ALI, they were divided into ALI group and non-ALI group. By univariate analysis of possible risk factors and correlation factors with statistical differences, the optimal critical value and predictive value of ALI were analyzed by drawing the operating characteristic curve (ROC curve) of the subjects. According to the optimal critical value, the related continuous variables are transformed into two classification variables, and the multivariate Logistic regression analysis is carried out. According to the OR value of each risk factor, the independent risk factors are assigned a score, and the prediction score table is established. Results: (1) the incidence of AAD complicated with ALI was about 44.76. (2) the WBC and CRP of BMI, in ALI group were higher than those in non-ALI group at admission, and there was significant difference between the two groups (P0.05 between). ALI group and non-ALI group). The patients in ALI group were more likely to be accompanied with pleural effusion on admission. The difference between the two groups was statistically significant (P0.05). (3). By drawing the ROC curve, the best critical value of BMI for predicting AAD complicated with ALI was 25.65kg/m2 (sensitivity was 87.5%). The best critical value for predicting AAD complicated with ALI with 40.5%), WBC was 15.00 脳 10 ~ 9 / L (sensitivity was 59.4%, specificity was 81.0%). The best critical value for AAD complicated with ALI by CRP was 15.81mg/L (sensitivity was 51.6%, specificity was 75.6%). At admission, the sensitivity and specificity of AAD complicated with ALI were 57.8 and 65.8 respectively. (4) by multivariate Logistic regression analysis, WBC 鈮，
本文编号：2338715
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