血清C反应蛋白、降钙素原、脑利尿钠肽联合检测对老年重症肺炎患者预后的预测价值  

Predictive value of serum C-reactive protein,procalcitonin,brain natriuretic peptide,and their combined detection for the prognosis of elderly patients with severe pneumonia

作　　者：朱俊 谢桂英 黄焕绍 ZHU Jun;XIE Guiying;HUANG Huanshao(Department of Laboratory Medicine,the First Dongguan Affiliated Hospital of Guangdong Medical University,Guangdong Province,Dongguan 523710,China;Department of Laboratory Medicine,Dongguan Guangji Hospital,Guangdong Province,Dongguan 523710,China)

机构地区：[1]广东医科大学附属东莞第一医院检验医学科,广东东莞523710 [2]广东省东莞市广济医院检验医学科,广东东莞523710

出　　处：《中国当代医药》2024年第28期131-134,共4页China Modern Medicine

基　　金：广东省东莞市社会发展科技项目(20231800937522)。

摘　　要：目的探讨血清C反应蛋白(CRP)、降钙素原(PCT)、脑利尿钠肽(BNP)及联合检测对老年重症肺炎(SP)患者预后的预测价值。方法选择2022年1月至2023年12月广东医科大学附属东莞第一医院收治的80例老年SP患者并设为SP组,选择同期80例普通肺炎患者并设为普通组。测定并比较两组PCT、CRP、BNP,比较不同预后老年SP患者的PCT、CRP、BNP,绘制受试者工作特征(ROC)曲线,分析PCT、CRP、BNP联合检测预测老年SP价值。结果SP组PCT、CRP、BNP检测值均高于普通组,差异有统计学意义(P<0.05);死亡组PCT、CRP、BNP检测值均高于生存组,差异有统计学意义(P<0.05);PCT检测预测老年SP预后的曲线下面积(AUC)为0.814,敏感度为0.786,特异度为0.731,约登指数为0.517;CRP检测预测老年SP预后的AUC为0.772,敏感度为0.750,特异度为0.712,约登指数为0.462;BNP检测预测老年SP预后的AUC为0.736,敏感度为0.714,特异度为0.654,约登指数为0.368;PCT、CRP、BNP联合检测预测老年SP预后的AUC为0.904,敏感度为0.857,特异度为0.827,约登指数为0.684。结论PCT、CRP、BNP均是评估老年SP患者病情及其预后的有效指标,三者联合检测可提高预测准确性,指导治疗。Objective To explore the predictive value of serum C-reactive protein(CRP),procalcitonin(PCT),brain natriuretic peptide(BNP),and their combined detection for the prognosis of elderly patients with severe pneumonia(SP).Methods A total of 80 elderly SP patients admitted to the First Dongguan Affiliated Hospital of Guangdong Medical University from January 2022 to December 2023 were selected as the SP group,and 80 patients with common pneumonia were selected as the normal group during the same period.The PCT,CRP and BNP of the two groups were measured and compared,the PCT,CRP and BNP of elderly SP patients with different prognoses were compared,receiver operating characteristic(ROC)curve was drawn,and the value of combined detection of PCT,CRP and BNP in predicting elderly SP was analyzed.Results The PCT,CRP and BNP values in the SP group were higher than those in the normal group,and the differences were statistically significant(P<0.05).The values of PCT,CRP and BNP in death group were higher than those in survival group,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of PCT was 0.814,the sensitivity was 0.786,the specificity was 0.731,and the Youden index was 0.517.The AUC,sensitivity and specificity of CRP to predict the prognosis of elderly SP were 0.772,0.750,0.712 and 0.462.The AUC,sensitivity and specificity of BNP to predict the prognosis of elderly SP were 0.736,0.714,0.654 and 0.368 respectively.The combined detection of PCT,CRP and BNP predicted the prognosis of elderly SP with an AUC of 0.904,sensitivity of 0.857,specificity of 0.827 and Youden index of 0.684.Conclusion PCT,CRP,and BNP are all effective indicators for evaluating the condition and prognosis of elderly SP patients.The combined detection of the three can improve prediction accuracy and guide treatment.

关 键 词：重症肺炎 C反应蛋白 降钙素原 脑利尿钠肽 预后 

分 类 号：R563[医药卫生—呼吸系统]