CURB-65评分联合S100A8可预测老年社区获得性肺炎患者住院死亡风险  

CURB-65 score combined with S100A8 predicts hospital death in elderly patients with community acquired pneumonia

作　　者：李晶 程清 丁敏 陈涛 鲍敏 郭红荣 陈瑾瑜 罗蔓 LI Jing;CHENG Qing;DING Min;CHEN Tao;BAO Min;GUO Hong-rong;CHEN Jin-yu;LUO Man(Department of Respiratory and Critical Care Medicine,Hubei Wuhan Third Hospital,Hubei Wuhan 430000,China;Department of Science and Education,Hubei Wuhan Third Hospital,Hubei Wuhan 430000,China;Department of Gastroenterology,Hubei Wuhan Third Hospital,Hubei Wuhan 430000,China;Department of Nursing,Hubei Wuhan Third Hospital,Hubei Wuhan 430000,China)

机构地区：[1]武汉市第三医院呼吸与危重症医学科,湖北武汉430000 [2]武汉市第三医院科教科,湖北武汉430000 [3]武汉市第三医院消化内科,湖北武汉430000 [4]武汉市第三医院护理部,湖北武汉430000

出　　处：《内科急危重症杂志》2024年第5期407-411,共5页Journal of Critical Care In Internal Medicine

基　　金：武汉市医学科研项目(WZ20C24)。

摘　　要：目的:评估CURB-65评分联合S100钙结合蛋白A8(S100A8)预测老年社区获得性肺炎(CAP)患者住院期间死亡的临床价值。方法:通过住院患者电子病历系统收集276例老年CAP患者的临床资料,根据住院期间生存状态,将其分为死亡组(64例)和生存组(212例)。采用多因素Logistic回归法筛选CAP患者住院期间死亡的独立危险因素,并采用受试者工作特征(ROC)曲线评估CURB-65评分联合S100A8预测老年CAP患者住院期间死亡的临床价值。结果:单因素分析显示,死亡组年龄>70岁、意识改变的患者比例以及血乳酸、白介素-6、S100A8水平、急性生理与慢性健康状况评估(APACHE II)及CURB-65评分高于生存组(P均<0.05)。多因素Logistic回归分析结果显示,年龄>70岁、S100A8>109 pg/mL、APACHE II评分>25分、CURB-65>2.85分是老年CAP患者住院期间全因死亡的独立危险因素。ROC曲线显示,CURB-65评分联合S100A8预测老年CAP患者住院死亡的曲线下面积高于单一S100A8、CURB-65评分,预测性能最高。结论:CURB-65评分、S100A8水平与老年CAP患者住院期间临床预后关系密切,联合应用可预测其住院期间全因死亡风险。Objective:To assess the clinical value of CURB-65 score combined with S100 calcium-binding protein A8(S100A8)in predicting death during hospitalization in elderly patients with community acquired pneumonia(CAP).Methods:The clinical data of 276 elderly patients with CAP were collected through the inpatient electronic medical record system,and they were divided into a death group(64 cases)and a survival group(212 cases)according to their survival status during hospitalization.Multifactorial logistic regression was used to screen the independent risk factors for death during hospitalization in CAP patients,and receiver operating characteristic(ROC)curves were used to assess the clinical value of the CURB-65 score combined with S100A8 in predicting death during hospitalization in elderly CAP patients.Results:Univariate analysis showed that the proportion of patients with age>70 years,altered consciousness,and blood lactate,IL-6,S100A8 levels,APACHE II and CURB-65 scores were higher in the death group than those in the survival group(all P<0.05).Multifactorial logistic regression analysis showed that age>70 years,S100A8>109 pg/mL,APACHE II score>25,and CURB-65>2.85 were independent risk factors for all-cause mortality during hospitalization in elderly patients with CAP.ROC curves showed that the area under the curve of the CURB-65 score combined with the S100A8 predicting death during hospitalization in elderly patients with CAP was higher than that of the single CURB-65 score and the S100A8,which had the highest predictive performance.Conclusion:CURB-65 score and S100A8 are closely related to the clinical prognosis of elderly CAP patients during hospitalization,and the combination of these scores can predict the risk of all-cause mortality during hospitalization.

关 键 词：社区获得性肺炎 CURB-65评分 S100钙结合蛋白A8 

分 类 号：R563.1[医药卫生—呼吸系统]