血清ChE、IL-6、UCR联合序贯器官衰竭评分预测重症肺炎患者病情与预后的价值  

Predictive value of serum ChE,IL-6 and UCR combined with score of sequential organ failure assessment in disease severity and prognosis of patients with severe pneumonia

作　　者：晏重敏 Yan Zhong-min(Department of Intensive Care Medicine,Anfu People's Hospital,Ji'an 343200,Jiangxi,China)

机构地区：[1]安福县人民医院重症医学科,江西吉安343200

出　　处：《四川生理科学杂志》2025年第1期12-14,29,共4页

基　　金：吉安市指导性科技计划项目(编号:20244-049202)。

摘　　要：目的:探究血清胆碱酯酶(Cholinesterase,ChE)、白细胞介素-6(Interleukin-6,IL-6)、血清尿素氮与肌酐比值(Urea-creatinine ratio,UCR)联合序贯器官衰竭(Sequential organ failure assessment,SOFA)评分预测重症肺炎患者病情与预后的价值。方法:选取2021年1月至2024年6月期间,安福县人民医院收治的60例重症肺炎患者作为研究对象(研究组),根据患者预后情况,将其分为死亡组(n=15)及存活组(n=45),取同期30例普通肺炎患者作为对照组,两组均接受常规治疗,对比分析两组患者的SOFA及血清ChE、IL-6、UCR等临床指标的差异。采用受试者工作特征(Receiver operation characteristic curve,ROC)曲线分析血清ChE、IL-6、UCR联合SOFA评分对重症肺炎患者预后的预测价值。结果:研究组患者的血清ChE水平低于对照组,IL-6、UCR水平及SOFA评分均高于对照组(P<0.05);研究组患者中,死亡组患者的血清ChE水平低于存活组,IL-6、UCR水平及SOFA评分均高于存活组(P<0.05);ROC曲线分析显示,重症肺炎血清ChE、IL-6、UCR、SOFA评分用于评估重症肺炎患者预后的曲线下面积(Area under the curve,AUC)分别为0.748、0.763、0.816、0.724,敏感度分别为66.67%、66.67%、68.89%、59.89%,特异度分别为60.00%、73.33%、73.33%、60.00%,四者联合的AUC、敏感度、特异度值分别是0.923、86.67%、60.00%。结论:血清ChE、IL-6、UCR水平与SOFA评分联合应用对重症肺炎患者病情与预后的预测能力价值较高。Objective:To explore the predictive value of serum cholinesterase(ChE),interleukin-6(IL-6)and urea-creatinine ratio(UCR)combined with score of sequential organ failure assessment(SOFA)in disease severity and prognosis of patients with severe pneumonia.Methods:A total of 60 patients with severe pneumonia admitted to Anfu County People's Hospital were enrolled as the research objects(study group)between January 2021 and June 2024.According to prognosis,they were divided into death group(n=15)and survival group(n=45).A total of 30 patients with common pneumonia during the same period were enrolled as control group.All patients underwent routine treatment.The differences in SOFA scores,serum ChE,IL-6 and UCR between the two groups were compared.The predictive value of serum ChE,IL-6 and UCR combined with SOFA score in prognosis of patients with severe pneumonia was analyzed by receiver operating characteristic(ROC)curves.Results:The level of serum ChE in study group was lower than that in control group,while IL-6,UCR levels and SOFA score were higher than those in control group(P<0.05).The level of serum ChE in death group was lower than that in survival group,while IL-6,UCR levels and SOFA score were higher than those in survival group(P<0.05).ROC curves analysis showed that area under the curve(AUC),sensitivity and specificity of serum ChE,IL-6,UCR and SOFA score for evaluating prognosis of patients with severe pneumonia were(0.748,0.763,0.816,0.724),(66.67%,66.67%,68.89%59.89%)and(60.00%,73.33%,73.33%,60.00%),respectively.AUC,sensitivity and specificity of combined detection were 0.923,86.67%and 60.00%,respectively.Conclusion:The combined detection of serum ChE,IL-6,UCR and SOFA score has high predictive value for disease severity and prognosis of patients with severe pneumonia.

关 键 词：重症肺炎 血清胆碱酯酶 白细胞介素-6 血清尿素氮与肌酐比值 序贯器官衰竭评分 

分 类 号：R563.1[医药卫生—呼吸系统]