C反应蛋白/前清蛋白比值与社区获得性肺炎患者病情的关系及对疾病转归的预测效能  

Relationship between C-Reactive Protein/Prealbumin Ratio and Disease and Predictive Efficacy of Disease Outcome in Patients with Community-Acquired Pneumonia

作　　者：石亚丽 张小蓬 郭建晖 陈婕 SHI Yali;ZHANG Xiaopeng;GUO Jianhui;CHEN Jie(Department of Laboratory,Nantong Haimen District People's Hospital,Nantong,Jiangsu 226100,China)

机构地区：[1]南通市海门区人民医院检验科,江苏南通226100

出　　处：《转化医学杂志》2024年第9期1424-1428,共5页Translational Medicine Journal

摘　　要：目的探讨C反应蛋白/前清蛋白比值(CRP/PAB)与社区获得性肺炎(CAP)患者病情的关系及对疾病转归的预测效能。方法选取2020年1月至2022年12月南通市海门区人民医院收治的126例CAP患者,根据CURB-65评分评估患者病情,并分入轻度组(95例),重度组(31例)。采用酶联免疫吸附法检测患者血清C反应蛋白、前清蛋白水平,并计算CRP/PAB。记录所有患者发病30 d的疾病转归情况。采用Pearson相关分析探讨CAP患者CRP/PAB与CURB-65评分的相关性。采用受试者工作特征(ROC)曲线评估CRP/PAB对CAP30d疾病转归的预测价值。采用多因素Logistic逐步回归分析探讨CAP患者疾病转归的影响因素。结果轻度组患者血清CRP、CRP/PAB水平低于重度组,PAB水平高于重度组患者(均P<0.05);CAP患者血清CRP、CRP/PAB与CURB-65评分均呈正相关,血清PAB水平与CURB-65评分成负相关(均P<0.05);存活组血清CRP,CRP/PAB水平明显低于死亡组,PAB水平高于死亡组(均P<0.05);ROC结果显示血清CRP、PAB及CRP/PAB预测CAP患者疾病转归的最佳截断值分别为128.65mg/L、91.43mg/L、2.03。CRP/PAB比值预测CAP患者疾病转归的曲线下面积(AUC)(95%CI)为0.915(0.877~0.963)。死亡组患者急性生理学及慢性健康状况Ⅱ(APACHEⅡ)评分、肺炎严重指数(PSI)评分高于存活组(P<0.05);多因素Logistic逐步回归分析显示,PSI评分(OR=4.162,95%CI:1.703~10.173)、APACHEⅡ评分(OR=3.854,95%CI:1.692~8.778)、CRP/PAB≥2.03(OR=5.244,95%CI:2.071~13.277)是CAP患者疾病转归的影响因素(P<0.05)。结论CRP/PAB比值与CAP患者病情及疾病转归密切相关,其对CAP患者临床转归具有一定的预测效能。Objective To explore the correlation between C-reactive protein/prealbumin ratio(CRP/PAB)and disease of cases with community-acquired pneumonia(CAP)and the predictive efficacy of the disease outcome.Methods A total of 126 patients with CAP were selected.The patients'conditions were evaluated according to CURB-65 score,and they were divided into mild group(n=95)and severe group(n=31).The levels of serum C-reactive protein and prealbumin were detected by enzyme-linked immunosorbent assay,and CRP/PAB were calculated.The disease outcomes of all patients were recorded 30 days after disease.The correlation between CRP/PAB and CURB-65 scores were evaluated by Pearson correlation.ROC was used to evaluate the predictive value of C-reactive protein/prealbumin ratio in 30d disease outcome of CAP.The influencing factors of disease outcome in cases with CAP were explored by multivariate Logistic stepwise regression.Results Serum CRP and CRP/PAB levels in mild group were lower than those in severe group,and PAB levels were higher compared with severe group(all P<0.05).Serum CRP and CRP/PAB in CAP patients were positively correlated with CURB-65 score,and serum PAB levels were negatively correlated with CURB-65 score(all P<0.05).Serum CRP and CRP/PAB levels in survival group were significantly lower than those in death group,and PAB levels were higher than those in death group(all P<0.05).ROC results showed that the best cut-off values of serum CRP,PAB and CRP/PAB for predicting disease outcome in CAP patients were 128.65 mg/L,91.43 mg/L and 2.03,respectively.The AUC(95%CI)of CRP/PAB ratio for predicting disease outcome in CAP patients was 0.915(0.877~0.963).APACHEⅡscores and PSI scores in death group were higher compared with survival group(P<0.05).PSI score(OR=4.162,95%CI:1.703-10.173),APACHEⅡscore(OR=3.854,95%CI:1.692-8.778),CRP/PAB≥2.03(OR=5.244,95%CI:2.071-13.277)were the influential factors for disease outcome in patients with CAP(P<0.05).Conclusion CRP/PAB ratio is closely related to the disease condition and disea

关 键 词：C反应蛋白/前清蛋白比值 社区获得性肺炎 病情 疾病转归:预测效能 

分 类 号：R563.1[医药卫生—呼吸系统]