血清相关生化指标联合肺炎程度评分与急诊重症肺炎患者预后的关系  

Relationship between serum related biochemical indicators combined with pneumonia severity score and prognosis of emergency patients with severe pneumonia

作　　者：袁亚丽 陈娟[1] 刘小娟 YUAN Ya-li;CHEN Juan;LIU Xiao-juan(Rugao Hospital Affiliated to Nantong University,Rugao 226500,China)

机构地区：[1]南通大学附属如皋医院,江苏如皋226500

出　　处：《实用医院临床杂志》2023年第6期141-145,共5页Practical Journal of Clinical Medicine

基　　金：江苏省卫生计生委科研基金资助项目(编号:H2020012)。

摘　　要：目的探讨血清糖基化终末产物受体(sRAGE)、降钙素原(PCT)联合CURB-65评分对急诊重症肺炎(SP)患者预后的评估价值。方法选取我院116例急诊SP患者,根据入院后28 d内的生存情况分为生存组(n=82)和死亡组(n=34),收集患者一般临床资料,于入院24 h内进行血常规、肝肾功能检测,计算CURB-65评分并测定血清sRAGE、PCT水平,比较两组上述指标差异,探讨急诊SP患者不良预后影响因素并分析血清sRAGE、PCT、CURB-65评分对急诊SP患者不良预后的预测价值。结果死亡组年龄、慢性心血管疾病占比、血肌酐、纤维蛋白酶原、血清C反应蛋白(CRP)、急性生理学及慢性健康状况评分系统(APACHEⅡ)、多器官功能障碍综合征(MODS)、临床肺部感染评分(CPIS)评分、血清sRAGE、PCT水平、CURB-65评分均高于生存组(P<0.05);血清PCR、sRAGE、PCT水平、APACHEⅡ、MODS、CURB-65评分是影响急诊SP患者不良预后的危险因素(P<0.05);血清sRAGE、PCT、CURB-65评分预测不良预后的AUC分别为0.833、0.853、0.862、0.965,敏感度为76.47%、76.47%、64.71%、91.17%,特异度为79.27%、80.49%、95.12%、86.58%,联合诊断价值较高。结论血清sRAGE、PCT、CURB-65评分是影响急诊SP患者不良预后的危险因素,可作为急诊SP临床预后的辅助评估指标。Objective To explore the value of serum soluble receptor for advanced glycation end products(sRAGE),procalcitonin(PCT)combined with CURB-65 score in evaluating the prognosis of emergency patients with severe pneumonia(SP).Methods A total of 116 emergency patients with SP in our hospital were selected.According to the survival situation within 28 days after admission,the patients were divided into a survival group(n=82)and a death group(n=34).The general clinical data of the patients were collected.Blood routine test and liver-kidney function test were performed within 24 hours after admission.CURB-65 score was calculated.The levels of serum sRAGE and PCT were detected.The differences in the above indicators were compared between the two groups.The influencing factors of poor prognosis in the emergency patients with SP were explored.The predictive value of serum sRAGE,PCT and CURB-65 score on the poor prognosis in emergency patients with SP was analyzed.Results The age,proportion of chronic cardiovascular disease,serum creatinine,fibrinogen,serum C-reactive protein(CRP),Acute Physiology and Chronic Health Evaluation II(APACHE II),Multiple Organ Dysfunction Syndrome(MODS),Clinical Pulmonary Infection Score(CPIS),serum sRAGE,PCT and CURB-65 score in the death group were higher than those in the survival group(P<0.05).Serum C-creative protein(CRP),sRAGE and PCT and scores of APACHE II,MODS and CURB-65 were risk factors for poor prognosis in the emergency patients with SP(P<0.05).The area under curves(AUCs)of ROC curve analysis of serum sRAGE,PCT,CURB-65 score alone and in combination in predicting poor prognosis in the emergency patients with SP were 0.833,0.853,0.862 and 0.965,respectively.The sensitivities were 76.47%,76.47%,64.71%and 91.17%and the specificities were 79.27%,80.49%,95.12%and 86.58%,respectively.The combined diagnostic value was higher.Conclusions Serum sRAGE,PCT and CURB-65 score are risk factors for the poor prognosis in emergency patients with SP.They can be used as auxiliary evaluation indicators

关 键 词：糖基化终末产物受体 降钙素原 CURB-65评分 重症肺炎 预后 

分 类 号：R563[医药卫生—呼吸系统]