监测血浆高密度脂蛋白对老年重症肺部感染患者的预测价值  

Predictive value of plasma high density lipoprotein for hospital death in elderly patients with severe pulmonary infection

作　　者：韩飚[1] 夏芝辉[2] 闫智杰[2] 潘毅[2] 程英[2] HAN Biao XIA Zhihui YAN Zhijie et al(Department of Respiratory and Critical Care Medicine ,the Fourth Affiliated Hospital of Nanchang University,Jiangxi Department of Critical Care Medicine ,the Fourth Affiliated Hospital of Nanchang University, Jiangxi, 330003, China.)

机构地区：[1]南昌大学第四附属医院呼吸与危重症医学科,南昌330003 [2]南昌大学第四附属医院重症医学科,南昌330003

出　　处：《江西医药》2017年第7期617-619,共3页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划;编号20155360

摘　　要：目的评价血浆高密度脂蛋白对老年重症肺部感染患者死亡的预测价值。方法回顾性分析2014年4月至2016年4月重症肺部感染患者的临床资料,记录入院第1、3、7d血浆高密度脂蛋白胆固醇(HDL-C)水平及其它临床数据,按28d预后分为死亡组与存活组,以受试者工作曲线(ROC)法和logistic回归分析研究HDL-C与患者死亡的关系。结果存活组与死亡组患者血浆HDL-C水平第1d(HDL-C1)、第3d(HDL-C3)、第7d(HDL-C7)组间差异有统计学意义。以HDL-C1、HDL-C3及HDL-C7为预测变量,其ROC曲线下面积分别为0.645,0.783及0.855,相应的95%CI为(0.508,0.782),(0.672,0.895)及(0.767,0.944),相应P值分别为0.044,0.000及0.000。以约登指数最大时为截断值取值,HDL-C1为1.03mmol/L,logistic回归模型分析优势比OR=6.286,95%CI(2.056,19.221)。结论监测HDL-C对老年重症肺部感染患者死亡有一定预测价值,可作为现有预后评估方法的有益补充。HDL-C7对死亡的预测价值优于HDL-C3,HDL-C3优于HDL-C1。Objective To evaluate the predictive value of plasma high density lipoprotein in the mortality of elderly patients with severe pulmonary infection. Methods Clinical datas were retrospectively analyzed from April 2014 to April 2016 with severe pulmonary infection,recorded on the 1,3,7 day of plasma high density lipoprotein cholesterol（HDL-C） levels and other clinical data,according to the 28 day prognosis was divided into death group and survival group,with the receiver operating curve（ROC）method and logistic regression analysis the relationship between HDL-C and death of patients. Results Plasma HDL-C levels of first day（HDL-C1）,third day（HDL-C3） and seventh day（HDL-C7） in survival group and death group patients were significant difference between the groups. When HDL-C1,HDL-C3 and HDL-C7 as predictor variables,the area under the curve of ROC were 0.645,0.783 and 0.855 respectively,corresponding to the 95%CI（0.508,0.782）,（0.672,0.895） and（0.767,0.944）,the corresponding p values were 0.044,0.000 and 0.000. with the largest Youden index for cut-off,HDL-C1 is 1.03mmol/L,logistic regression model to analyze the OR=6.286,95%CI（2.056,19.221）. Conclusion Monitoring HDL-C in elderly patients with severe pulmonary infection has a certain predictive value,which can be used as a useful complement to the existing prognostic evaluation method.HDL-C7 is better than HDL-C3,HDL-C3 is better than HDL-C1.

关 键 词：高密度指蛋白 肺部感染 死亡 

分 类 号：R563.1[医药卫生—呼吸系统]