[1]张世宝,秦凤霞.脓毒症合并呼吸衰竭患者中心静脉血氧饱和度动态变化的影响因素及预后预测价值研究[J].陕西医学杂志,2026,(8):1097-1101,1107.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.014]
　ZHANG Shibao,QIN Fengxia.Influencing factors of dynamic changes of central venous oxygen saturation and its prognostic predictive value in sepsis patients with acute respiratory failure[J].,2026,(8):1097-1101,1107.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.014]
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脓毒症合并呼吸衰竭患者中心静脉血氧饱和度动态变化的影响因素及预后预测价值研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1097-1101,1107
栏目:
临床研究
出版日期:
2026-08-05

文章信息/Info

Title:
Influencing factors of dynamic changes of central venous oxygen saturation and its prognostic predictive value in sepsis patients with acute respiratory failure
作者:
张世宝1; 秦凤霞2
（1.中国药科大学附属江宁中医院 南京市江宁中医院重症医学科，江苏 南京 211100；2.江苏省中西医结合医院重症医学科，江苏 南京 210028）
Author(s):
ZHANG Shibao1; QIN Fengxia2
(1.Department of Critical Care Medicine,Jiangning Traditional Chinese Medicine Hospital Affiliated to China Pharmaceutical University,Nanjing 211100,China;2.Department of Critical Care Medicine,Jiangsu Provincial Hospital of Integrated Traditional Chinese
关键词:
脓毒症; 呼吸衰竭; 中心静脉血氧饱和度; 动态变化; 影响因素; 预后
Keywords:
Sepsis; Respiratory failure; Central venous oxygen saturation; Dynamic changes; Influencing factors; Prognosis
分类号:
R 631
DOI:
DOI:10.3969/j.issn.1000-7377.2026.08.014
文献标志码:
A
摘要:
目的：探讨脓毒症合并呼吸衰竭患者入院48 h内中心静脉血氧饱和度（ScvO2）动态变化的影响因素及其变化对患者预后的预测价值。方法：选取100例脓毒症合并呼吸衰竭患者，根据入院48 h内ScvO2动态变化特征分为动态稳定组（52例）和动态异常组（48例）。多因素Logistic回归分析脓毒症合并呼吸衰竭患者ScvO2动态变化异常的影响因素。随访28 d，记录患者生存情况，并分为生存组（73例）和病死组（27例）。受试者工作特征（ROC）曲线评估入院48 h内ScvO2最大波动幅度对脓毒症合并呼吸衰竭患者28 d内生存情况的预测价值。结果：动态异常组年龄、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）、序贯器官衰竭评估（SOFA）评分、血乳酸（Lac）、C-反应蛋白（CRP）、降钙素原（PCT）、机械通气时间、重症监护病房（ICU）住院时间、血管活性药物使用比例、感染性休克比例、48 h液体复苏量高于动态稳定组，氧合指数低于动态稳定组（均P＜0.05）。年龄、APACHEⅡ评分、感染性休克、血Lac是脓毒症合并呼吸衰竭患者入院48 h内ScvO2动态变化异常的独立影响因素（均P＜0.05）。动态异常组28 d内病死率为39.58%高于动态稳定组15.38%（P＜0.05）。病死组患者入院48 h内ScvO2最大波动幅度高于生存组（P＜0.05）。入院48 h内ScvO2最大波动幅度预测脓毒症合并呼吸衰竭患者28 d内病死的曲线下面积（AUC）为0.782（P＜0.05）。结论：脓毒症合并呼吸衰竭患者入院48 h内ScvO2动态变化异常的影响因素包括年龄、APACHEⅡ评分、感染性休克、Lac，且ScvO2动态变化可预测患者预后。
Abstract:
Objective:To investigate the influencing factors of dynamic changes of central venous oxygen saturation (ScvO2) within 48 hours after admission in sepsis patients with acute respiratory failure,and the predictive value of its changes for patient prognosis.Methods:A total of 100 sepsis patients with acute respiratory failure were selected,and they were divided into dynamic stable group (52 cases) and dynamic abnormal group (48 cases) according to the characteristics of ScvO2 dynamic changes within 48 hours after admission.Multivariate Logistic regression was used to analyze the influencing factors of abnormal ScvO2 dynamic changes in sepsis patients with acute respiratory failure.All patients were followed up for 28 days,and their survival status was recorded.They were divided into survival group (73 cases) and non-survival group (27 cases).ROC curve was used to evaluate the predictive value of the maximum fluctuation amplitude of ScvO2 within 48 hours after admission for the 28-day survival status of sepsis patients with acute respiratory failure.Results:The age,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA) score,blood lactate (Lac),C-reactive protein (CRP),procalcitonin (PCT),mechanical ventilation duration,intensive care unit (ICU) length of stay,proportion of vasoactive drug use,proportion of septic shock and 48-hour fluid resuscitation volume in the dynamic abnormal group were higher than those in the dynamic stable group,while the oxygenation index was lower than that in the dynamic stable group (all P<0.05).Age,APACHEⅡ score,septic shock and blood Lac were independent influencing factors for abnormal ScvO2 dynamic changes within 48 hours after admission in sepsis patients with acute respiratory failure (all P<0.05).The 28-day mortality rate in the dynamic abnormal group was 39.58%,which was higher than 15.38% in the dynamic stable group (P<0.05).The maximum fluctuation amplitude of ScvO2 within 48 hours after admission in the non-survival group was higher than that in the survival group (P<0.05).The AUC of the maximum fluctuation amplitude of ScvO2 within 48 hours after admission for predicting 28-day mortality in sepsis patients with acute respiratory failure was 0.782 (P<0.05).Conclusion:The influencing factors of abnormal ScvO2 dynamic changes within 48 hours after admission in sepsis patients with acute respiratory failure include age,APACHEⅡ score,septic shock and Lac,and the dynamic changes of ScvO2 can predict the prognosis of patients.

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备注/Memo

备注/Memo:
江苏省自然科学基金资助项目（2023JSZR-120632）
更新日期/Last Update: 2026-08-13