3项炎性指标检测在重症肺炎患者病情变化及预后评估中的应用研究  

Application research of 3 kinds of inflammatory indexes for the assessment of disease and prognosis in patients with severe pneumonia

作　　者：张雷[1] 马云杰[2] 乔梁[1] 司朝辉[1] 梁颖[1] 

机构地区：[1]河北省沧州市中心医院检验科,061001 [2]河北省沧州市中心医院急诊科,061001

出　　处：《检验医学与临床》2015年第20期3065-3067,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨降钙素原（PCT）、白细胞介素6（IL-6）、C反应蛋白（CRP）在重症肺炎患者病情变化及预后评估中的应用价值。方法收集该院2012-2014年收治的重症肺炎患者共96例,根据治疗28d后患者存活与否分为存活组（n=58）和死亡组（n=38）,回顾性分析两组患者在治疗1、4、7、28d时PCT、IL-6、CRP水平及APACHEⅡ评分差异,采用ROC曲线分析以上4项指标的曲线下面积（AUC）。结果随着治疗时间的增加,存活组患者PCT、CRP水平均有不同程度下降,治疗期间平均水平分别为（8.34±1.39）μg/L、（61.25±8.17）mg/L;死亡组PCT、CRP水平则明显上升,治疗期间平均水平分别为（14.38±2.58）μg/L、（98.87±13.24）mg/L,两组间差异有统计学意义（P〈0.05）。该趋势与APACHEⅡ评分变化情况相符合,存活组和死亡组的APACHEⅡ平均分分别为（38.95±3.76）、（69.53±7.11）分,差异有统计学意思（P〈0.05）。治疗期间两组患者IL-6水平均呈下降趋势。PCT、IL-6、CRP、APACHEⅡ的AUC分别为0.851、0.787、0.653、0.861。结论 PCT、CRP及IL-6均可在一定程度上反映重症肺炎患者的病情程度,其中PCT及CRP水平能较好地反映病情变化及预后情况。Objective To discuss the values of procalcitonin（PCT）,interleukin 6（IL-6）,and C reactive protein（CRP）for assessment of disease and prognosis in patients with severe pneumonia.Methods 96 cases of severe pneumonia patients admitted to the hospital from 2012 to 2014were collected and divided into survival group（n=58）,death group（n=38）,according to the survival of patients after 28-day treatment.The levels of PCT,IL-6,CRP and APACHE Ⅱ of two groups respectively after treated for 1,4,7,28 dwere retrospective analyzed,and the areas under curve（AUCs）of the 4kinds of indexes were calculated by ROC analysis.Results The levels of PCT and CRP of survival group decreased with the increase of treatment time,which mean levels during treatment were（8.34±1.39）μg/L and（61.25±8.17）mg/L respectively.And the levels of PCT and CRP of death group increased with the increase of treatment time,which mean levels during treatment were（14.38±2.58）μg/L and（98.87±13.24）mg/L respectively.The difference of two groups were significantly（P〈0.05）.The change trends of PCT and CRP were consistent with the change of APACHEⅡ scoring system.The APACHEⅡ scores of survival group and death group were（38.95±3.76）and（69.53±7.11）respectively,with statistical difference（P〈0.05）.The IL-6levels of both groups had shown a downward trend during the treatment.The AUCs of PCT,IL-6,CRP,and APACHEⅡwere 0.851,0.787,0.653,0.861 respectively.Conclusion PCT,CRP and IL-6can reflect some severity of sever pneumonia,of which PCT and CRP can reflect the change of disease and its prognosis better than IL-6.

关 键 词：重症肺炎 降钙素原 白细胞介素6 C反应蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]