实用医学杂志 ›› 2021, Vol. 37 ›› Issue (19): 2477-2481.doi: 10.3969/j.issn.1006⁃5725.2021.19.009

• 临床研究 • 上一篇    下一篇

灌注指数作为足月儿脓毒性休克患儿血管活性药物需求预测指标的评估

刘雪琴1 张卫星1 沈洁1 刘玉霞1 唐成和2   

  1. 1 新乡市中心医院,新乡医学院第四临床学院(河南新乡453000);2 新乡医学院第一附属医院 (河南新乡453100)

  • 出版日期:2021-10-10 发布日期:2021-10-10
  • 通讯作者: 张卫星 E⁃mail:zhangweixing0420@126
  • 基金资助:
    河南省医学科技攻关计划联合共建项目(编号:LHGJ20191319,2018020926)

Effect of perfusion index in the prediction of vasoactive drug demands in term infants with septic shock

LIU Xueqin*,ZHANG Weixing,SHEN Jie,LIU Yuxia,TANG Chenghe.   

  1. Neonatal Intensive Care Unit,Xinxiang Central Hospital,Xinxiang 453000,China

  • Online:2021-10-10 Published:2021-10-10
  • Contact: ZHANG Weixing E⁃mail:zhangweixing0420@126.com

摘要:

目的 评估灌注指数(perfusion index,PI)在预测新生儿脓毒性休克患儿早期复苏过程中血 管活性药物需求的作用。方法 选择新乡市中心医院 2018 1 月至 2020 06 月入住新生儿重症监护室 neonatal intensive care unit,NICU)的诊断为新生儿脓毒性休克的病例 56 例,均为足月儿,根据是否需要使用血管活性药物分为血管活性药物组和非血管活性药物组,需要血管活性药物的有 31 例,不需要使用血管活性药物的病例有 25 例。结果 (1)PI 预测血管活性药物需求的临界值为 0.28,灵敏度为 90.3%,特异性为 96%,AUC 0.96(95% CI:0.91 ~ 1.00;P < 0.001);(2)动脉血乳酸预测升压药需求的临界值为 5.45 mg/dL,灵敏度为 74.2%,特异性为 92%,AUC 0.89(95% CI:0.81 ~ 0.97;P < 0.001);(3)其他灌注变 量不能预测严重脓毒性休克患儿血管活性药物的需求。结论 PI 和动脉血乳酸水平可以很好地预测足 月儿脓毒性休克患儿是否需要使用血管活性药物

关键词:

灌注指数, 脓毒性休克, 足月儿, 血管活性药物, 动脉血乳酸, 新生儿重症监护室

Abstract:

Objective To evaluate the role of perfusion index(PI)in predicting the demands in neonates with septic shockfor vasoactive drugs during early recovery. Methods A total of 56 term infants with neonatal septic shock hospitalized in the neonatal intensive care unit(NICU)of Xinxiang Center Hospital from January 2018 to June 2020 were divided into vasoactive drug group(n = 31)and non⁃vasoactive drug group(n = 25)according to the need to use vasoactive drugs. Results (1)The cut ⁃ off value of PI in predicting the neonates′ vasoactive demands was 0.28,the sensitivity andthe specificity were 90.3% and 96%,respectively and the AUC was 0.96(95% CI:0.91 ~ 1.00;P < 0.001).(2)The cut⁃off value of the arterial lactate level in predicting their vasoactive demands was 5.45 mg/dL,the sensitivity and specificity were 74.2% and 92%,respectively and the AUC was 0.89(95% CI:0.81 ~ 0.97;P < 0.001).(3)Other perfusion variables failed to predict their vasoactive demands in the septic shock infants. Conclusion PI and arterial lactate levels can predict the demands in septic shock infants for vasoactive drugs.

Key words:

perfusion index, septic shock, term infant, vasoactive drugs, arterial blood lactic acid, neonatal intensive care unit