PCT和VEGF动态监测在老年获得性肺炎的治疗及预后评估价值  

Dynamic monitoring of VEGF and PCT in the treatment and prognosis of elderly patients with hospital acquired pneumonia infection

作　　者：冯正航 罗俊峰 何发标 

机构地区：[1]柳州市第四人民医院呼吸内科,广西柳州545000 [2]藤县人民医院ICU,广西梧州543300

出　　处：《临床肺科杂志》2015年第8期1419-1423,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的动态监测老年获得性肺炎患者血清降钙素原(PCT)与血管内皮生长因子(VEGF)的浓度,探讨分析其对于老年院内获得性肺炎患者的治疗价值以及预后评估价值。方法收集整理我院获得性肺炎感染的老年患者88例作为试验组,将试验组患者根据病情程度分为重症组及轻、中症组,并随机选取同期就诊于我院门诊的无感染的老年人50例作为对照组,观察记录所有患者的一般资料,检测记录患者第1天及第8天的血清降钙素原与血管内皮生长因子的浓度。结果第1天检查结果显示:重症组的PCT及VEGF、Hs-CRP均高于对照组(P<0.05),重症组各指标均高于轻、中症组(P<0.05),轻、中症组PCT、VEGF与对照组差异无统计学意义(P>0.05)。第8天检查结果显示:重症组和轻、中症组的PCT及VEGF、Hs-CRP均较第1天降低,重症组患者PCT及VEGF、Hs-CRP仍然高于对照组(P<0.05),轻、中症组Hs-CRP仍然高于对照组(P<0.05)。VEGF与APACHEⅡ评分始终成正相关(P<0.05)。血清PCT的灵敏度为35.5%,特异度为100%,约登指数35.5%;血清VEGF的灵敏度为90.3%,特异度为59.6%,约登指数49.9%;Hs-CRP的灵敏度为100%,特异度为3.51%,约登指数3.51%。其中VEGF约登指数最高。结论动态监测血清VEGF、PCT可以辅助Hs-CRP弥补临床指标的不足,尤其是VEGF,可以作为反映患者疾病情况及预后评估的重要指标,帮助医护人员了解老年院内获得性肺炎患者在治疗过程中病情变化情况。Objective To explore the diagnostic and prognostic value of dynamic monitoring on serum pro- calcitonin （PCT） and vascular endothelial growth factor （VEGF） in elderly patients with hospital-acquired pneumo- nia infection. Methods 88 elderly patients with hospital-acquired pneumonia infection were selected as the experi- ment group, who were divided into the mild, moderate and severe groups according to the disease severity, and an- other 50 elderly people without infection were taken as the control group. The general information of all patients was recorded. The levels of serum PCT and VEGF were recorded on the 1st and 8th days. Results On the first day, the levels of PCT and VEGF in the severe group were higher than the control group （ P 〈 0.05 ） , and the indexes were all higher in the severe group than in the mild and moderate group （ P 〈 0.05 ）. There was no significant difference in PCT and VEG among the mild group, the moderate group and the control group （P 〉 0. 05 ）. On the 8th day, the levels of PCT, VEGF and Hs-CRP all decreased in the study group, and they were still higher in the severe group than in the control group and the level of Hs-CRP was still higher in the mild and moderate group than in the control group （ P 〈 0. 05 ）. VEGF and APACHE lI score Showed a positive correlation （ P 〈 0. 05 ）. The sensitivity of serum PCT was 35.5% , 100% of specificity, and 35.5% of Youden index. The sensitivity of serum VEGF was 90. 3%, 59. 6% of specificity, and 49. 9% of Youden index. The sensitivity of Hs-CRP was 100%, 3.51% of specificity, 3.51% of Youden index. Conclusion Dynamic monitoring of VEGF and PCT can compensate for the lack of Hs- CRP, in particular that VEGF can be used as an important indicator of disease status and prognosis of elderly patients with hospital-acquired pneumonia.

关 键 词：血清降钙素原 血管内皮生长因子 老年 院内获得性肺炎 预后评估 

分 类 号：R563.1[医药卫生—呼吸系统]