APACHE Ⅲ评分及血清降钙素原对老年重症肺炎的病情及预后评估价值  

Evaluation value of APACHE Ⅲ score and serum procalcitonin on severity and prognosis of elderly patients with severe pneumonia

作　　者：付艳华[1] 金湘东[2] 索冬卫[3] 彭芳[3] 

机构地区：[1]郑州大学第五附属医院心肺康复科,450052 [2]郑州铁路职业技术学院医学系,450052 [3]郑州大学第五附属医院急诊科,450052

出　　处：《淮海医药》2017年第5期529-531,共3页Journal of Huaihai Medicine

摘　　要：目的:探讨急性生理和慢性健康状况评分系统Ⅲ(APACHE Ⅲ)及血清降钙素原(PCT)对老年重症肺炎病情及预后的评估价值。方法:将我院急诊内科收治的124例老年人重症肺炎患者根据APACHE II分为A组37例,B组46例,C组41例,并选择同期老年健康体检患者50例为健康组。根据患者1周内预后情况分为存活组(51例)和死亡组(73例)。比较分析各组患者APACHE Ⅲ评分及PCT水平的变化。结果:入院第1天,B组,C组APACHE Ⅲ评分、血清PCT显著高于A组和健康组(P<0.05),而B组,C组之间差异无统计学意义(P>0.05);入院第3天,3组重症肺炎患者血清PCT,APACHE Ⅲ评分较健康组显著升高,且随着重症肺炎病情的加重,患者血清PCT,APACHE Ⅲ评分依次增加(P<0.05);与存活组比较,死亡组入院第1天和第3天APACHE Ⅲ评分显著升高(P<0.05)。入院第3天,死亡组血清PCT水平显著高于存活组(P<0.05);入院第1天、第3天,患者血清PCT与APACHE Ⅲ评分均呈线性正相关(P<0.05)。结论:血清PCT水平检测联合APACHE Ⅲ评分对老年重症肺炎患者的病情严重程度以及评估预后具有重要意义。Objective： To explore the evaluation value of serum procalcitonin （PCT） and APACHE Ⅲ score on severity and prognosis of elderly patients with severe pneumonia.Methods： According to the severity of the disease,124 elderly severe pneumonia patients were divided into 3 groups,including 37 patients in group A,46 in group B,and 41 in group C,and compared with 50 healthy elderly persons in a control group.All the patients were also divided into a survivor group and a death group according to the prognosis in one week.Serum PCT and APACHE Ⅲ score were detected and compared.Results： On the first day after admission,the APACHE Ⅲ score and serum PCT in groups B and C were significantly higher than those in group A and the control group （P 0.05）,while there was no significant difference between groups B and C （P 0.05）.Serum PCT and APACHE Ⅲ score in the severe pneumonia groups on the third day after admission were significantly higher than those in the control group,and with severity aggravating,serum PCT and APACHE Ⅲ score increased （P 0.05）.Compared with the survivor group,APACHE Ⅲ score in the death group on the first day and third day after admission and serum PCT on the third day after admission increased （P 0.05）.There was significant positive relation between serum PCT and APACHE Ⅲ score on the first day and third day after admission in severe pneumonia patients （P 0.05）.Conclusion： Serum PCT level detection united with APACHE Ⅲ score evaluation is of great importance in the evaluation of severity and prognosis in elderly severe pneumonia patients.

关 键 词：重症肺炎 血清降钙素原 APACHE Ⅲ评分 老年人 

分 类 号：R563.1[医药卫生—呼吸系统]