Application value of extravascular lung water index and pulmonary vascular permeability index in patients with acute respiratory distress syndrome / 中国综合临床

ABSTRACT

Objective To investigate the value of extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) in the diagnosis and treatment of acute respiratory distress syndrome(ARDS).Methods From February 2015 to October 2016,selected 80 patients with ARDS in Danzhou Municipal People's Hospital,including 19 cases mild patients,28 cases moderate cases and 33 cases severe cases.The patients' EVLWI,PVPI,acute physiology and chronic health score system Ⅱ (APACHE Ⅱ)score,lung injury score (LIS) were detected.Results The score of APACHE Ⅱ in severe group was 22.81(21.91,25.40) points,significantly higher than that in mild group (19.81 (18.12,21.10) points) and moderate group(20.07 (19.01,22.02),P =0.002).The LIS,EVLWI and PVPI in Severe group were 2.01(1.83,2.11) points,17.01 (14.82,23.02) ml/kg and 3.82 (3.01,5.01),significantly higher than that in mild group (1.01 (0.98) points,1.7412.71 (10.89,13.67) ml/kg,2.71 (2.36,2.94)) and moderate group (1.52 (1.36,1.91) points,14.21 (13.10,16.60) ml/kg,3.01 (2.52,3.03),P ＜ 0.05),LIS,EVLWI and PVPI in moderate group were significantly higher than the mild group (P＜0.05).The mortality rate of 28 d in moderate and severe group was 32.14％ (9/28) and 51.52％ (17/33),which was significantly higher than that in mild group 0.00％(0/19) (P＜0.05).EVLWI and PVPI were 19.12(17.22,22.96) ml/kg and 3.71(3.08,5.22) in patients with death,which were significantly higher than those in survival 14.19 (11.20,16.59) ml/kg and 2.97(2.31,3.10) (P=0,021 and 0.016);EVLWI was positively correlated with PVPI,LIS and APACHE Ⅱ score(rs =0.411,0.323 and 0.304,P＜ 0.001).PVPI was positively correlated with LIS and APACHE Ⅱ score (rs =0.346,0.297,P＜0.001).No correlation between LIS and APACHE Ⅱ score (P＞0.05).Conclusion EVLWI and PVPI have certain apphcation value in the diagnosis and treatment of ARDS,and it is related to the patient's condition and prognosis.