降钙素原联合CURB-65评分、PSI评分对重症肺炎诊断及预后的预测  

The predictive value of procalcitonin combined with CURB-65 score,PSI score in the diagnosis and prognosis of severe pneumonia

作　　者：曹大龙 李运成[1] CAO Da-long(Department of respiratory medicine,Bengbu First People’s Hospital,Bengbu 233000,China)

机构地区：[1]蚌埠市第一人民医院呼吸内科,安徽蚌埠233000

出　　处：《牡丹江医学院学报》2020年第1期25-28,共4页Journal of Mudanjiang Medical University

基　　金：国家自然科学基金专项(81370168)。

摘　　要：目的探讨降钙素原(procalcitonin,PCT)、CURB-65评分和肺炎严重指数(pneumonia severity index,PSI)评分对重症肺炎诊断及预后的预测价值。方法回顾性分析2018年7月至2019年7月间我院呼吸内科收治的111例肺炎患者的临床资料,根据重症肺炎诊断标准分组,记录患者28天内死亡率,受试者工作特征(receiver operating characteristic,ROC)曲线分析PCT、CURB-65评分和PSI评分对重症肺炎诊断及预后的预测价值。结果重症组患者PCT水平、CURB-65评分及PSI评分均显著高于普通组(P<0.05);重症组中死亡患者PCT水平、CURB-65评分及PSI评分均显著高于重症组除死亡外的其他患者(P<0.05)。ROC曲线预测重症肺炎显示:PCT的曲线下面积(Area Under Curve,AUC)为0.914,CURB-65评分AUC为0.822,PSI评分AUC为0.882。PCT联合CURB-65评分的AUC为0.928,PCT联合PSI评分的AUC为0.954。ROC曲线预测重症组患者死亡显示:PCT评分的AUC为0.731,CURB-65评分的AUC为0.704,PSI评分的AUC为0.723,PCT联合CURB-65的AUC为0.758,PCT联合PSI评分的AUC为0.750。结论PCT、CURB-65评分、PSI评分均能有效预测重症肺炎诊断及其预后情况,PCT联合CURB-65评分或PSI评分预测重症肺炎诊断及其预后的价值更高。Objective To explore the predictive value of procalcitonin(PCT),CURB-65 score and pneumonia severity index(PSI)score in the diagnosis and prognosis of severe pneumonia.Methods The clinical data of 141 patients of pneumonia admitted to respiratory department of our hospital from July 2018 to July 2019 were retrospectively analyzed.Patients were grouped according to the diagnostic criteria of severe pneumonia.The mortality rate was recorded within 28 days.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of PCT,CURB-65 score and PSI score in the diagnosis and prognosis of severe pneumonia.Results The level of PCT,CURB-65 score and PSI score in severe group were significantly higher than those in normal group(P<0.05).The level of PCT,CURB-65 score and PSI score of the dead patients in severe group were significantly higher than those of other patients in severe group(P<0.05).The results of ROC predicting severe pneumonia showed the area under curve(AUC)of PCT was 0.914,AUC of CURB-65 score was 0.822,AUC of PSI score was 0.882,AUC of PCT combined with CURB-65 score was 0.928,AUC of PCT combined with PSI score was 0.954.The mortality of ROC patients in severe group showed the AUC of PCT was 0.731,AUC of CURB-65 score was 0.704,AUC of PSI score was 0.723,AUC of PCT combined with CURB-65 score was 0.758,AUC of PCT combined with PSI score was 0.750.Conclusion PCT,CURB-65 score and PSI score can effectively predict the diagnosis and prognosis of severe pneumonia.PCT combined with CURB-65 score or PSI score has higher value in predicting the diagnosis and prognosis of severe pneumonia.

关 键 词：降钙素原 CURB-65评分 肺炎严重指数评分 重症肺炎 诊断 预后 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]