HBP、IGF、PCT水平在脑梗死并发医院获得性肺炎诊断和病情评价中的价值  

Values of HBP,IGF and PCT in diagnosis of hospital-acquired pneumonia in cerebral infarction patients and evaluation of illness condition

作　　者：雷颖 宋水江[2] 汪涛 刘蕾 徐小华 徐凯丽 LEI Ying;SONG Shui-jiang;WANG Tao;LIU Lei;XU Xiao-hua;XU Kai-li(The Quzhou Affiliated Hospital of Wenzhou Medical University,Quzhou People′s Hospital,Quzhou,Zhejiang 324000,China;不详)

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院)呼吸与危重症医学科,浙江衢州324000 [2]浙江大学第二附属医院神经内科,浙江杭州310000 [3]温州医科大学附属衢州医院(衢州市人民医院)感染科,浙江衢州324000 [4]温州医科大学附属衢州医院(衢州市人民医院)检验科,浙江衢州324000

出　　处：《中华医院感染学杂志》2022年第18期2777-2780,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金项目(8217050116)。

摘　　要：目的 分析肝素结合蛋白(HBP)、胰岛素样生长因子(IGF)、降钙素原(PCT)在急性脑梗死(ACI)并发医院获得性肺炎(HAP)的诊断和病情评估中的价值。方法 选取2019年1月-2021年1月衢州市人民医院收治的115例ACI并发HAP患者为研究组,147例未发生HAP患者为对照组。收集患者基础资料,检测入组当日外周血WBC、中性粒细胞百分比(NEU)、HBP、IGF、PCT等实验室指标。结果 研究组患者年龄、合并糖尿病、具有脑卒中病史比例及入院当日的NIHSS评分、APACHEⅡ评分均高于对照组,入院当日的GCS评分低于对照组(P<0.05);研究组患者WBC、HBP、IGF-2、PCT水平均高于对照组,IGF-1水平低于对照组(P<0.05);重症HAP患者HBP、IGF-2、PCT水平均高于非重症HAP患者,IGF-1水平低于非重症HAP患者(P<0.05);受试者工作特征(ROC)曲线显示,在最佳界值下,HBP诊断ACI并发HAP灵敏度最高,WBC的特异度最高;HBP预测重症HAP的灵敏度最高,PCT的特异度最高。结论 ACI并发HAP患者表现为HBP、IGF-2、PCT水平升高和IGF-1水平降低,重症HAP患者上述指标的变化幅度更大,这些指标对于HAP的诊断和病情评价均具有辅助价值。OBJECTIVE To analyze the values of heparin-biding protein(HBP),insulin-like growth factor(IGF) and procalcitonin(PCT) in diagnosis of hospital-acquired pneumonia(HAP) in patients with acute cerebral infarction(ACI) and evaluation of illness condition.METHODS A total of 115 ACI patients complicated with HAP who were treated in Quzhou People′s Hospital from Jan 2019 to Jan 2021 were assigned as the study group,and 147 patients who were not complicated with HAP were chosen as the control group.The baseline data were collected from the patients,and the laboratory test indexes including peripheral blood WBC,neutrophils percentage(NEU),HBP,IGF and PCT were detected on the day of enrollment.RESULTS The proportions of patients with age,diabetes mellitus and stroke history,NIHSS score and APACHE Ⅱ score on the day of admission were significantly higher in the study group than in the control group,while the GCS score of the study group was significantly lower than that of the control group on the day of admission(P<0.05).The levels of WBC,HBP,IGF-2 and PCT of the study group were significantly higher than those of the control group,while the IGF-1 level of the study group was significantly lower than that of the control group(P<0.05).The levels of HBP,IGF-2 and PCT of the patients with severe HAP were significantly higher than those of the patients with non-severe HAP,while the IGF-1 level of the patients with severe HAP was significantly lower than that of the patients with non-severe HAP(P<0.05).Receiver operating characteristic(ROC) curve analysis showed that under the optimal critical value,the sensitivity of HBP was the highest in diagnosis of HAP in the ACI patients,the specificity of WBC was the highest;the sensitivity of HBP was the highest in prediction of severe HAP,and the specificity of PCT was the highest.CONCLUSION The ACI patients complicated with HAP show the rise of levels of HBP,IGF-2 and PCT and the decline of IGF-1 level,the patients with greater HAP show greater changes of above indexes,and the ind

关 键 词：肝素结合蛋白 胰岛素样生长因子 降钙素原 脑梗死 医院获得性肺炎 

分 类 号：R742[医药卫生—神经病学与精神病学]