目的: 分析外周血超敏C反应蛋白/白蛋白比值(HCAR)、诱骗受体3(DcR3)与急性呼吸衰竭患者机械通气撤机结局的关系。方法: 选取2020年11月至2021年11月接受机械通气治疗的102例急性呼吸衰竭患者为研究对象,根据撤机结局分为撤机失败组(n=21)、撤机成功组(n=81)。比较两组自主呼吸测试(SBT)前、撤机后外周血HCAR、DcR3水平,分析HCAR、DcR3水平与急性呼吸衰竭患者撤机失败的关系,外周血HCAR、DcR3水平联合对急性呼吸衰竭患者撤机失败的预测价值,分析不同水平HCAR、DcR3发生撤机失败危险度。结果: 撤机失败组SBT前、撤机后外周血HCAR、DcR3水平高于撤机成功组(P＜0.05);Logistic分析发现,外周血HCAR、DcR3水平与急性呼吸衰竭患者撤机失败显著相关(P＜0.05);SBT前、撤机后外周血HCAR、DcR3水平联合预测优于单独预测;SBT前、撤机后外周血HCAR、DcR3水平高水平发生撤机失败的危险度是低水平的1.125、1.633、1.893、2.236倍(P＜0.05)。结论: 急性呼吸衰竭患者外周血HCAR、DcR3水平增加,各指标联合可以为预测急性呼吸衰竭患者机械通气撤机结局提供参考。
Objective: To analyze the relationship between peripheral blood high-sensitivity C-reactive protein/albumin ratio (HCAR), decoy receptor 3 (DcR3) and the outcome of weaning from mechanical ventilation in patients with acute respiratory failure. Methods: A total of 102 patients with acute respiratory failure who received mechanical ventilation from November 2020 to November 2021 were selected as the research objects. According to the outcome of weaning, they were divided into the weaning failure group (n=21) and the weaning success group (n=81). The peripheral blood HCAR and DcR3 levels were compared between the two groups before spontaneous breathing test (SBT) and after weaning, and the relationship between HCAR and DcR3 levels and the failure of weaning in patients with acute respiratory failure was analyzed. The predictive value of weaning failure was analyzed, and the risk of weaning failure at different levels of HCAR and DcR3 was analyzed. Results: The levels of HCAR and DcR3 in peripheral blood before and after SBT in the weaning failure group were higher than those in the successful weaning group (P＜0.05). Logistic analysis showed that the levels of peripheral blood HCAR and DcR3 were significantly correlated with the failure of weaning in patients with acute respiratory failure. (P＜0.05); the combined prediction of peripheral blood HCAR and DcR3 levels before SBT and after weaning was better than independent prediction; the risk of weaning failure with high levels of peripheral blood HCAR and DcR3 before SBT and after weaning was low 1.125, 1.633, 1.893, 2.236 times (P＜0.05). Conclusion: The levels of HCAR and DcR3 in peripheral blood of patients with acute respiratory failure are increased, and the combination of these indicators can provide a reference for predicting the outcome of mechanical ventilation weaning in patients with acute respiratory failure.
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