Logistic回归模型的建立及联合因子对老年脓毒症合并ARDS的预测诊断研究

刘金华; 李喆; 廖敏; 朱应群

doi:10.13201/j.issn.1009-5918.2021.01.010

Logistic回归模型的建立及联合因子对老年脓毒症合并ARDS的预测诊断研究

- 长沙市第三医院呼吸与危重症医学科(长沙, 410015)

详细信息

通讯作者: 朱应群,E-mail:ljhygox@126.com

中图分类号: R737.9

收稿日期: 2020-06-12

Logistic regression model establishment and predictive diagnosis research of the combination factor for the elderly sepsis with ARDS

- Department of Respiratory and Critical Diseases, the Third Hospital of Changsha, Changsha, 410015, China

More Information

Corresponding author: ZHU Yingqun, E-mail: ljhygox@126.com

Received Date: 12 June 2020

摘要

摘要: 目的:建立Logistic回归模型,评估联合因子对老年脓毒症合并急性呼吸窘迫综合征(ARDS)的诊断价值及预后。方法:回顾性分析我院2018年1月—2019年12月期间收治的76例老年脓毒症患者作为研究对象,根据其是否合并ARDS分为ARDS组(n=40)和非ARDS组(n=36)。收集两组患者基本资料、实验室生化检测结果,采用Logistic回归模型分析老年脓毒症合并ARDS的危险因素,并通过受试工作曲线(ROC)比较不同指标的预测诊断价值。结果:ARDS组患者血浆CRP、TNF-α、IL-6、PCT及SP-D水平分别为(129.03±22.27) mg/L、(55.14±9.58) ng/L、(151.49±39.03)μg/L、(13.05±3.23)μg/L和(67.02±11.54) g/L,APACHEⅡ评分为(19.87±3.77)分,均显著高于非ARDS组患者(P<0.05)。回归分析显示CRP、SP-D及急性生理与慢性健康评分(APACHEⅡ)对脓毒症合并ARDS具有早期预测价值(P<0.05)。CRP、SP-D、APACHEⅡ评分及联合因子对老年脓毒症合并ARDS诊断的ROC曲线下面积ACU分别为0.869、0.880、0.854和0.942,联合因子对老年脓毒症合并ARDS的诊断效能最佳,其敏感度、特异度分别为80.0%、97.2%。结论:CRP、SP-D及APACHEⅡ评分及其联合因此可作为老年脓毒症患者合并ARDS的早期诊断的观察指标,联合因子的诊断价值优于单一指标评估,对辅助临床脓毒症合并ARDS早期诊断具有重要意义。
- Logistic回归模型 /
- 脓毒症 /
- 急性呼吸窘迫综合征 /
- 预测 /
- 诊断
Abstract: Objective: To establish the Logistic regression model, and evaluate the diagnostic value and the prognosis of the combination factor for sepsis elderly patients complicated with acute respiratory distress syndrome(ARDS) and.Methods: A retrospective analysis of 76 elderly patients with sepsis admitted to our hospital from January 2018 to December 2019 was chosen, and divided into ARDS group(n=40) and non-ARDS group(n=36) according to whether combined with ARDS. Basic data and laboratory biochemical test results of patients in the two groups were collected. Logistic regression model was used to analyze the risk factors of elderly sepsis complicated with ARDS. ROC curve was used to compare the predictive diagnostic value of different indicators.Results: The plasma levels of CRP, TNF-α, IL-6, PCT and SP-D in ARDS group were(129.03±22.27) mg/L,(55.14±9.58) ng/L,(151.49±39.03) μg/L,(13.05±3.23) μg/L and(67.02±11.54) g/L, respectively. The APACHE Ⅱ score was(19.87±3.77) points, which were all significantly higher than those in non-ARDS group(P<0.05). Regression analysis showed that CRP, SP-D and APACHE Ⅱ score had early predictive value for septic ARDS(P<0.05 2). The ROC curve of CRP, SP-D, APACHE Ⅱ score and combined factor were 0.869, 0.880, 0.854 and 0.942 respectively in the diagnosis of elderly sepsis complicated with ARDS. Combined factor showed the best diagnostic efficacy for elderly sepsis complicated with ARDS, and its sensitivity and specificity were 80.0% and 97.2%, respectively.Conclusion: CRP, SP-D and APACHE Ⅱ score and their combination factor could be used as observation indicators for the early diagnosis of ARDS in elderly patients with sepsis. The diagnostic value of combined factors was better than that of single indicator, which was of great significance for assisting the early diagnosis of ARDS in clinical sepsis.
- Logistic regression model /
- sepsis /
- acute respiratory distress syndrome /
- prediction /
- diagnosis

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