动态监测血浆降钙素原水平在老年社区获得性肺炎患者病情和预后评估中的临床价值  

Significance of dynamic monitoring of plasma level of procalcitonin in evaluating the condition and prognosis in elderly patients with community acquired pneumonia

作　　者：孙雪莲[1] 章建东[1] 谭志敏[1] 刘冰[1] SUN Xue-lian;ZHANG Jian-dong;TAN Zhi-min(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China.)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《临床和实验医学杂志》2019年第5期553-556,共4页Journal of Clinical and Experimental Medicine

基　　金：首都医科大学基础-临床科研合作基金(编号:15JL24)

摘　　要：目的探讨动态监测血浆降钙素原水平在老年社区获得性肺炎病情和预后评估中的临床价值。方法回顾性分析2016年1月至2018年10月在首都医科大学附属北京友谊医院接受治疗的160例老年社区获得性肺炎患者的临床资料。根据肺炎严重指数(PSI)评分将患者分为4级,其中Ⅰ级患者21例,Ⅱ级患者67例,Ⅲ级患者43例;Ⅳ级患者29例,比较不同分级患者的血浆降钙素原水平;根据患者预后不同分为生存组与死亡组,其中生存组129患者,死亡组31患者,比较两组患者入院时,以及入院第1天、第3天、第5天以及第7天的血浆降钙素原水平;利用Pearson分析软件分析患者预后与血浆降钙素原水平的相关性。结果患者PIS评分等级越高,患者体内降钙素原水平越高;存活组患者在入院第1天降钙素原水平为(2. 37±0. 81) ng/ml,入院第3天降钙素原水平为(1. 93±0. 72) ng/ml,入院第5天降钙素原水平为(1. 74±0. 51) ng/ml,入院第7天降钙素原水平为(1. 43±0. 62) ng/ml,随着入院治疗时间的延长降钙素原水平下降,死亡组患者的降钙素原水平逐渐升高,同一时段与存活组患者相比,差异具有统计学意义(P <0. 05);患者的预后结果与入院第3天、第5天以及第7天的降钙素原水平之间均存在相关性。结论降钙素原作为临床老年社区获得性肺炎的诊断指标,动态监测其水平可以反映感染严重程度,并反映患者预后情况,值得临床推广应用。Objective To explore the application of dynamic level of procalcitonin in diagnosis and evaluating the prognosis of elderly patients with community acquired pneumonia.Methods The clinical data of 160 elderly patients with community acquired pneumonia treated in this hospital during January 2016 to October 2018 were retrospectively analyzed.These patients were divided into 4 grades according to pneumonia severity index(PSI)scores.There were 21 patients with grade I,67 patients with grade II,43 patients with grade III,and 29 patients with grade IV,and their levels of procalcitonin were compared among patients with different grades.These patients were divided into survival group(129 patients)and death group(31 patients)according to theiir prognosis.Plasma levels of procalcitonin at admission,1 st day,3 rd day,5 th day and 7th day were compared between these two groups.The correlation between prognosis and procalcitonin level was analyzed by Pearson analysis software.Results The higher the patient's PIS scores were,the larger the content of procalcitonin in these patients;the survival group were(2.37±0.81)ng/ml in admission for 1 day,and the admission was(1.93±0.72)ng/ml for 3 days.It was(1.74±0.51)ng/ml,and the content of patients in hospital was(1.43±0.62)ng/ml for 7 days.With the prolonged progesterone level,the procalcitonin level in patients of death group was gradually increased.There was significant difference in the survival rate among these patients in survival group(P<0.05).There was correlation between the prognosis of these patients and procalcitonin levels at 3 rd,5 th,and 7 th days after admission.Conclusion As a diagnostic indicator for clinical community acquired pneumonia,level of procalcitonin can reflect the severity of infection and the prognosis of patients,hence it is worthy to be applied for clinical promotion.

关 键 词：老年社区获得性肺炎 降钙素原 动态监测 预后 

分 类 号：R563.1[医药卫生—呼吸系统]