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中华重症医学电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 183 -186. doi: 10.3877/cma.j.issn.2096-1537.2020.02.016

所属专题: 文献

临床研究

早期肌钙蛋白I对危重孕产妇重症监护病房住院时间的预测价值
王光杰1, 赵慧颖1, 吕杰1, 安友仲1,()   
  1. 1. 100044 北京大学人民医院重症医学科
  • 收稿日期:2019-12-26 出版日期:2020-05-28
  • 通信作者: 安友仲

Value of initial increase of troponin I level for prediction of prolonged ICU stay in critically Ill obstetric patients

Guangjie Wang1, Huiying Zhao1, Jie Lyu1, Youzhong An1,()   

  1. 1. Department of Critical Care Medicine, Peking University People′s Hospital, Beijing 100044, China
  • Received:2019-12-26 Published:2020-05-28
  • Corresponding author: Youzhong An
  • About author:
    Corresponding author: An Youzhong, Email:
引用本文:

王光杰, 赵慧颖, 吕杰, 安友仲. 早期肌钙蛋白I对危重孕产妇重症监护病房住院时间的预测价值[J/OL]. 中华重症医学电子杂志, 2020, 06(02): 183-186.

Guangjie Wang, Huiying Zhao, Jie Lyu, Youzhong An. Value of initial increase of troponin I level for prediction of prolonged ICU stay in critically Ill obstetric patients[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(02): 183-186.

目的

评估入重症监护病房(ICU)早期出现肌钙蛋白I(TnI)升高对重症孕产妇ICU住院时间的预测价值。

方法

对2014年1月1日至2019年7月1日入住北京大学人民医院ICU的危重孕产妇的临床资料进行回顾性分析。根据入住ICU住院时间是否大于72 h,分为ICU住院时间延长和ICU住院时间非延长2个组。采用多因素Logistic回归方法分析ICU住院时间延长的独立危险因素。采用受试者工作特征(ROC)曲线评价入ICU早期TnI水平及AKI对ICU住院时间延长的预测价值。

结果

本研究纳入转入ICU的危重孕产妇119例;其中ICU住院时间延长组47例(39.5%),非延长组72例(60.5%)。Logistic回归分析发现,早期TnI升高(优势比6.697,95%CI:1.27~35.332,P=0.025)和急性肾损伤(AKI,优势比6.054,95%CI:1.248~29.368,P=0.025)是危重孕产妇ICU住院时间延长的独立危险因素。ROC曲线分析显示,入ICU早期发生TnI升高及AKI对ICU住院时间延长预测的曲线下面积分别为0.741(95%CI 0.65~0.832,P<0.001)和0.729(95%CI 0.634~0.825,P<0.001);二者联合对ICU住院时间延长预测的曲线下面积为0.806(95%CI 0.723~0.889,P<0.001)。

结论

早期出现TnI升高和AKI是预测危重孕产妇ICU住院时间延长的独立危险因素,对ICU住院时间有预测价值。

Objective

To evaluate the value of initial increase of troponin I (TnI) level for prediction of prolonged intensive care unit (ICU) stay in critically ill obstetric patients.

Methods

A retrospective analysis was conducted in critically ill obstetric patients who were admitted to the ICU between January 2014 and July 2019. We divided the patients into two groups based on whether the time of stay in ICU was longer than 72 hours. Independent risk factors for stay in ICU were identified by multivariate analysis. Predictive value of initial TnI level and acute kidney injury (AKI) for ICU stay was assessed by receiver operating curve (ROC) analysis.

Results

There were 119 critically ill obstetric patients included in the study. ICU stay was prolonged in 47 cases (≥72 hours). Multivariate analysis identified that the initial increase of cardiac TnI (odds ratio=6.697, 95%CI: 1.27~35.332, P=0.025) and AKI (odds ratio=6.054, 95%CI: 1.248~29.368, P=0.025) were independent predictors for prolonged ICU stay. The areas under the reciever operating characteristic of initial increase of TnI level alone, AKI alone, and their combination for prediction of ICU stay were 0.741 (95%CI 0.65-0.832, P<0.001), 0.729 (95%CI 0.634-0.825, P<0.001), and 0.806 (95%CI 0.723-0.889, P<0.001), respectively.

Conclusion

Increased TnI level and occurence of AKI at the early ICU admission are independent risk factors for ICU stay in critically ill obstetric patients.

表1 危重孕产妇ICU住院时间延长与非延长的单因素分析
表2 危重孕产妇ICU住院时间延长的多因素分析
图1 早期TnI升高及AKI对ICU住院时间延长预测价值的ROC曲线
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