| 摘要: |
| 目的 探讨肺超声（LUS）、胸片及实验室指标预测新冠肺炎（COVID-19）危重型患者预后的临床价值。方法 选取收治于贵州医科大学附属医院重症监护病房的COVID-19危重症患者63例，入院后行床旁LUS检查（八分区）及LUS评分，并于超声检查前后48h内行床旁胸片检查、胸片评分。收集患者临床资料及实验室指标，根据患者预后情况分为死亡组和存活组，分析两组患者的LUS评分、胸片评分以及实验室指标与预后的相关性，绘制ROC曲线，分析LUS评分、胸片评分、LUS联合胸片、LUS联合Pco2对COVID-19危重型患者预后预测的价值。结果 死亡组白细胞计数、Pco2均高于存活组，Spo2、PH均低于存活组，LUS及胸片评分均高于存活组，差异均有统计学意义（p<0.05）；单因素Logistic回归结果显示：LUS、胸片评分增高将增加患者的死亡风险（OR=1.22，p=0.010/OR=1.31，p=0.010）；受试者工作曲线（ROC曲线）显示：LUS、胸片评分单独评估COVID-19危重症患者预后的曲线下面积分别为0.708、0.696，超声略优于胸片。两者联合评估的曲线下面积为0.725，优于单独评估。LUS联合Pco2的评估效能最好，曲线下面积为0.790。结论 八分区LUS评分评估COVID-19危重症患者预后略优于胸片评分，两者联合评估优于单独评估，LUS评分联合Pco2的评估效能最好。 |
| 关键词: 新冠肺炎，危重症，肺超声，胸片，预后。 |
| DOI： |
| 投稿时间：2023-09-12修订日期：2023-10-28 |
| 基金项目:国家自然科学基金(81960315) |
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| Lung ultrasound, chest radiographs and laboratory indices for predicting the prognosis of a critical form of covid-19 Clinical Value |
| Wumingcui,Wangruoyan,Zhangli,Zhaolina,Lisha,Zhangbei |
| () |
| Abstract: |
| Objective：Investigating the clinical value of lung ultrasound (LUS), chest radiographs and laboratory indices in predicting the prognosis of critically ill patients with COVID-19.Method: Sixty-three COVID-19 critically ill patients admitted to the intensive care unit of the Affiliated Hospital of Guizhou Medical University were selected, and bedside LUS examination (8-zone) and LUS score were performed after admission, and bedside chest radiography and chest radiography score were performed 48h before and after ultrasonography. The patients' clinical data and laboratory indexes were collected, and the patients were divided into the death group and the survival group according to their prognosis, and the correlation between the LUS scores, chest radiograph scores, and laboratory indexes and prognosis of the two groups was analysed, and the ROC curves were drawn to analyse the value of LUS scores, chest radiograph scores, LUS combined with chest radiographs, and LUS combined with Pco2 in the prognostic prediction of patients with the critically ill type of COVID-19.Results:Leukocyte count and Pco2 were higher in the death group than in the survival group, Spo2 and PH were lower than in the survival group, and LUS and chest film scores were higher than in the survival group, and the differences were statistically significant (p<0.05); the results of the one-way logistic regression showed that an increase in LUS and chest film scores would increase the risk of death of the patients (OR=1.22, p=0.010/OR=1.31, and p=0.010); the subjects' working curve (ROC curve) showed that the area under the curve for LUS and chest radiograph scores alone to assess the prognosis of COVID-19 critically ill patients were 0.708 and 0.696, respectively, and ultrasound was slightly better than chest radiograph. The area under the curve for the combined assessment of the two was 0.725, which was superior to that of the separate assessment.LUS combined with Pco2 had the best assessment efficacy, with an area under the curve of 0.790.Conclusions:The 8-zone LUS score was slightly better than the chest radiograph score in assessing the prognosis of critically ill patients with COVID-19, and the combination of the two was better than the separate assessments, with the best efficacy of the LUS score in combination with Pco2. |
| Key words: COVID-19 Critically ill Lus Chest radiograph Prognosis. |
