SAA、HBP水平和NAP积分与重症颅脑损伤患者继发肺部感染及预后的关系  

Relationship between serum SAA,HBP levels and NAP score and secondary pulmonary infection and prognosis in patients with severe craniocerebral injury

作　　者：张宁[1] 施振华[2] 唐文学[1] 王磊[1] 景云烟 林乐清[1] ZHANG Ning;SHI Zhenhua;TANG Wenxue;WANG Lei;JING Yunyan;LIN Leqing(Department of Critical Care Medicine,Affiliated Hospital,Hangzhou Normal University,Hangzhou 310000,CHINA)

机构地区：[1]杭州师范大学附属医院重症医学科,浙江310000 [2]杭州师范大学附属医院神经外科,浙江310000

出　　处：《江苏医药》2024年第10期1028-1031,共4页Jiangsu Medical Journal

摘　　要：目的探讨血清淀粉样蛋白A(SAA)、肝素结合蛋白(HBP)水平和中性粒细胞碱性磷酸酶(NAP)积分与重症颅脑损伤患者继发肺部感染及预后的关系。方法选取重症颅脑损伤继发肺部感染患者100例作为感染组,同期收治的重症颅脑损伤未继发肺部感染患者100例作为对照组。比较两组临床资料及SAA、HBP水平和NAP积分;绘制ROC曲线分析SAA、HBP水平和NAP积分对重症颅脑损伤患者继发肺部感染的预测价值。根据感染组患者预后情况,将其分为预后良好组(44例)和预后不良组(56例),比较两组患者SAA、HBP水平和NAP积分。结果入院第3天,感染组SAA、HBP水平和NAP积分均高于对照组(P<0.05)。ROC曲线分析显示,SAA、HBP水平和NAP积分联合检测预测重症颅脑损伤患者继发肺部感染的AUC为0.991[95%CI(0.972~0.998),P<0.05]。治疗1周后,预后良好组SAA、HBP水平和NAP积分均低于预后不良组(P<0.05)。结论重症颅脑损伤继发肺部感染患者SAA、HBP水平和NAP积分较高,且在预后不良患者中更高。同时检测SAA、HBP水平和NAP积分对评估重症颅脑损伤患者继发肺部感染具有临床意义。Objective To investigate the relationship between serum amyloid A(SAA),heparin-binding protein(HBP)levels and neutrophil alkaline phosphatase(NAP)score and the development of secondary pulmonary infection and prognosis in the patients with severe craniocerebral injury.Methods A total of 100 patients with secondary pulmonary infection after severe craniocerebral injury were selected as group A.Another 100 patients with severe craniocerebral injury without pulmonary infection during the same period were selected as group C.The clinical data,SAA and HBP levels and NAP score of the two groups were compared.ROC curve was used to analyze the value of SAA,HBP levels and NAP score in predicting the secondary pulmonary infection of the patients with severe craniocerebral injury.According to the prognosis,the patients in group A were subdivided into group A1(with good prognosis,44 cases)and group A2(with poor prognosis,56 cases).The levels of SAA,HBP and NAP score were compared between groups of A1 and A2.Results The levels of SAA,HBP and NAP score were significantly higher in group A than those in group C(P<0.05).ROC curve analysis showed that the AUC of combined detection of SAA,HBP levels and NAP score in predicting secondary pulmonary infection of the patients with severe craniocerebral injury was 0.991[95%CI(0.972~0.998),P<0.05].The levels of SAA and HBP and NAP score in group A1 were lower than those in group A2(P<0.05).Conclusion The levels of SAA and HBP and NAP score are higher in the patients with severe craniocerebral injury complicated with secondary pulmonary infection,which are much higher in the patients with poor prognosis.Combined detection of SAA,HBP levels and NAP score in predicting the pulmonary infection secondary to severe craniocerebral injury has clinical significance.

关 键 词：血清淀粉样蛋白A 肝素结合蛋白 中性粒细胞碱性磷酸酶积分 重症颅脑损伤 肺部感染 预后 

分 类 号：R651[医药卫生—外科学]