临床肺部感染评分和降钙素原对评估老年重症社区获得性肺炎患者病情和预后的意义  

Clinical pulmonary infection score and procalcitonin for assessing the severity and prognosis of elderly patients with severe community acquired pneumonia

作　　者：谢君杰[1] 易汛[1] 徐昉 Xie Junjie1, H Xun1, Xu Fang2(1.Department of Internal Medicine, Chongqing Three Gorges Central Hospital, Chongqing 404000, China;2.Department of Internal Medicine, Wanzhou District People＇s Hospital, Chongqing 404000, Chin)

机构地区：[1]重庆三峡中心医院内科,重庆404000 [2]重庆市万州区人民医院内科,重庆404000

出　　处：《中华实验和临床感染病杂志（电子版）》2018年第1期61-64,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金面上项目(No.81570069)

摘　　要：目的研究临床肺部感染评分(CPIS)和降钙素原(PCT)对老年重症社区获得性肺炎(SCAP)患者病情和预后的评估价值。方法收集2014年2月至2016年2月于本院进行诊治的60例老年SCAP患者为研究对象,根据预后分为生存组和死亡组,检测两组患者入院第1天、第7天的PCT、白细胞(WBC)水平、肺部感染评分(CPIS)评分差异及其与CPIS的相关性。结果与入院第1天相比,生存组患者治疗7 d后PCT水平和CPIS值显著下降(P均<0.001);治疗前后WBC计数水平差异无统计学意义。与入院第1天相比,死亡组患者治疗7 d后WBC、PCT和CPIS指标差异均无统计学意义。治疗7 d后,组间比较PCT和CPIS差异具有统计学意义(P均<0.05);第1天SCAP患者WBC、PCT、CPIS与预后均无相关性;第7天SCAP患者WBC与预后无相关性(P>0.05),第7天SCAP患者PCT及CPIS与SCAP的预后相关(r=0.44、P=0.023,r=0.58、P=0.017)。结论 PCT和CPIS与老年SCAP患者的病情严重程度和预后相关,可作为评估SCAP预后的良好生物学标记,从而指导进一步治疗。Objective To investigate the value of clinical pulmonary infection score （CPIS） and procalcitonin （PCT） in the treatment of elderly patients with severe community-acquired pneumonia （SCAP）. Methods Total of 60 elderly patients with SCAP in our hospital from February 2014 to February 2016 were collected. According to the prognosis, the patients were divided into survival group and death group. The difference of PCT, white blood cell （WBC）, CPIS score between the two groups at the first day and 7th day after hospital admission were detected and their correlations with CPIS were analyzed. Results Compared with the first day, the levels of PCT and CPIS in the survival group were not significantly decreased at the 7th day after hospital admission （P all 0.05）. Compared with the first day, the levels of WBC, PCT and CPIS in the death group were not significantly changed （P all 〉 0.05）. After 7 days treatment, there were significant difference in PCT and CPIS between the two groups （P all 〈0.05）. WBC, PCT, and CPIS in SCAP patients had no significant correlation with prognosis on the first day （P all 〉 0.05）. After 7 days treatment, WBC was not associated with prognosis （P 〉 0.05）, and PCT and CPIS were significantly correlated with the prognosis of SCAP （r = 0.44, P = 0.023; r = 0.58, P = 0.017）. Conclusions PCT and CPIS were associated with severity and prognosis in elderly patients with SCAP in elderly patients. It could be used as a good biomarker for evaluating the prognosis of SCAP, which could be used for further treatment.

关 键 词：临床肺部感染评分 降钙素原 重症社区获得性肺炎 白细胞 

分 类 号：R563.1[医药卫生—呼吸系统]