血清血管生成素2和颗粒蛋白前体与老年重症肺炎合并呼吸衰竭患者预后的关系  

The Relationship Between Serum Angiopoietin 2 and Granuloprotein precursor Levels and Prognosis in Elderly Patients with Severe Pneumonia and Respiratory Failure

作　　者：李薇 王丹 LI Wei;WANG Dan(Department of Critical Care Medicine,Northern Theater Command General Hospital,Shenyang 110000,China)

机构地区：[1]北部战区总医院重症医学科,沈阳110000

出　　处：《中国药物经济学》2024年第6期88-91,101,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨血清血管生成素2(Ang-2)和颗粒蛋白前体(PGRN)与老年重症肺炎合并呼吸衰竭患者预后的关系。方法选取2021年1月至2022年12月北部战区总医院收治的291例重症肺炎合并呼吸衰竭患者作为研究对象,剔除2例病历资料缺失患者,共纳入289例患者。根据28d的临床转归情况,将患者分为生存组(234例)和死亡组(55例)。对老年重症肺炎合并呼吸衰竭患者死亡影响因素进行Logistic回归分析。结果生存组和死亡组患者性别、年龄、体重指数(BMI)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分评分、高血压、糖尿病、白细胞计数、中性粒细胞计数、淋巴细胞计数、Ang-2、PGRN比较,差异有统计学意义(P<0.05)。治疗前生存组与死亡组血清Ang-2水平比较差异有统计学意义(P<0.05),而PGRN水平差异无统计学意义(P>0.05)。随着治疗的进行,Ang-2水平的差异逐渐增大,生存组Ang-2水平在治疗后1 d、7 d和28 d均显著低于死亡组(P<0.05)。生存组PGRN水平在治疗后1 d、7 d和28 d均显著低于死亡组(P<0.05)。老年重症肺炎合并呼吸衰竭患者死亡的主要危险因素包括年龄、高血压、糖尿病、白细胞计数、中性粒细胞计数、APACHEⅡ评分、Ang-2水平、PGRN。ROC曲线分析结果显示,治疗前血清Ang-2水平在预测患者是否生存方面表现出较高的敏感性为0.75,以及相对较好的特异性为0.68,AUC面积为0.81;治疗前血清PGRN水平的敏感性稍低为0.62,但特异性为0.72,AUC面积为0.799。结论血清Ang-2和PGRN与合并呼吸衰竭的老年重症肺炎预后有关,监测其水平对病情诊断、治疗和预后具有重要的临床意义。Objective To explore the relationship between serum angiopoietin 2(Ang-2)and granuloprotein precursor(PGRN) and prognosis of elderly patients with severe pneumonia complicated with respiratory failure.Methods A total of 291 patients with severe pneumonia combined with respiratory failure admitted to the Northern Theater Command General Hospital from January 2021 to December 2022 were selected as the study objects.2 patients with missing case data were excluded,and a total of 289 patients were included.According to the clinical outcome at 28 days,the patients were divided into survival group(234 cases)and death group(55 cases).Logistic regression analysis was performed to analyze the influencing factors of death in elderly patients with severe pneumonia complicated with respiratory failure.Results There were significant differences in gender,age,body mass index(BMI),acute physiology and Chronic Health status Scoring System Ⅱ(APACHEⅡ)score,hypertension,diabetes,white blood cell count,neutrophil count,lymphocyte count,Ang-2 and PGRN between survival group and death group(P<0.05).Before treatment,there was significant difference in serum Ang-2 level between survival group and death group(P<0.05),but no significant difference in serum PGRN level(P>0.05).With the progress of treatment,the difference of Ang-2 level increased gradually,and the Ang-2 level in survival group was significantly lower than that in death group on day 1,7 and 28 after treatment(P<0.05).The level of PGRN in the survival group was significantly lower than that in the death group on day 1,7 and 28 after treatment(P<0.05).The main risk factors for death in elderly patients with severe pneumonia combined with respiratory failure included age,hypertension,diabetes,white blood cell count,neutrophil count,APACHEⅡ score,Ang-2 level,and PGRN.ROC curve analysis showed that pre-treatment serum Ang-2 levels showed a high sensitivity of 0.75 and a relatively good specificity of 0.68 in predicting survival.The AUC area is 0.81.The sensitivity of serum P

关 键 词：血管生成素2 颗粒蛋白前体 重症肺炎 呼吸衰竭 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]