CURB-age联合NT-proBNP对老年CAP患者预后的预测价值  

Predictive value of CURB-age combined with NT-proBNP in elderly patients with CAP

作　　者：许立增 马璐璐 潘林林 王敏[1] XU Lizeng;MA Lulu;PAN Linlin;WANG Min(Department of Emergency Medicine,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院急诊科,山东潍坊261031

出　　处：《潍坊医学院学报》2024年第1期33-36,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生健康委员会科研项目(项目编号:WFWSJK-2023-030)。

摘　　要：目的 探讨CURB-age联合氨基末端钠尿肽前体(NT-proBNP)对老年社区获得性肺炎(CAP)患者30d死亡率的预测价值。方法 回顾性分析2021年12月~2023年6月于我院急诊科住院治疗的CAP患者130例,按患者是否于就诊后30d内死亡分为生存组(n=104)和死亡组(n=26)。收集病历资料,比较两组患者的各项基线资料,分析影响急诊老年初诊CAP患者30d死亡率的独立危险因素,绘制ROC曲线比较各协变量与联合预测因子预测效能。结果 (1)两组患者性别、年龄、体重、GCS评分、RR、收缩压、舒张压、BUN、PLT、RDW、D-D二聚体无明显差异(P>0.05);(2)存活组NT-proBNP、WBC、CRP、PCT、随机血糖、CURB-65评分、CURB-age评分低于死亡组,PA高于死亡组(P<0.05);(3)多因素Logistic回归显示CURB-age评分、WBC、CRP是急诊门诊老年初诊CAP患者30d死亡的独立危险因素(P<0.05);(4)联合预测因子的最佳临界值为0.32,AUC为0.956,高于NT-proBNP和CURB-age评分对老年初诊CAP患者住院30d病死率预测的效果(P<0.05)。结论 CURB-age联合NT-proBNP可显著提升急诊老年CAP患者30d死亡率的预测价值,临床可推广应用。Objective To investigate the predictive value of CURB-age combined with N-terminal pro-natriuretic peptide(NT-proBNP) for 30-day mortality in elderly patients with community-acquired pneumonia(CAP).Methods A total of 130 patients with CAP hospitalized in the emergency department from December 2021 to June 2023 were retrospectively analyzed.The patients were divided into survival group(n=104) and death group(n=26) according to whether they died within 30 days after admission.The baseline data of the two groups were compared.The independent risk factors for 30 days mortality in elderly patients with newly diagnosed CAP in the emergency department were analyzed,and the ROC curve was drawn to compare the predictive efficacy of each covariate and combined predictor.Results There were no significant differences in sex,age,weight,GCS score,RR,systolic blood pressure,diastolic blood pressure,BUN,PLT,RDW,D-dimer between the two groups(P>0.05).The levels of NT-proBNP,WBC,CRP,PCT,random blood glucose,CURB-65 score and CURB-age score in the survival group were lower than those in the death group,and PA was higher than that in the death group(P<0.05).Multivariate Logistic regression showed that CURB-age score,WBC and CRP were independent risk factors for 30-day mortality in elderly patients with newly diagnosed CAP in the emergency department(P<0.05).The best cut-off value of the combined predictor was 0.32,and the AUC was 0.956,which was higher than that of NT-proBNP and CURB-age score for predicting 30-day mortality in elderly patients with newly diagnosed CAP(P<0.05).Conclusion CURB-age combined with NT-proBNP can significantly improve the predictive value of 30-day mortality in elderly patients with CAP in the emergency department,and can be used actively in clinical practice.

关 键 词：CURB-age NT-PROBNP 急诊门诊 老年CAP 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]