降钙素原在社区获得性肺炎预后评估中的价值

发布时间：2018-05-04 05:07

本文选题：社区获得性肺炎 + 降钙素原　；参考：《中国呼吸与危重监护杂志》2017年02期

【摘要】：目的评价入院降钙素原(procalcitonin,PCT)水平在社区获得性肺炎(community-acquired pneumonia,CAP)严重性分层及预后评估中的价值;评价PCT结合经过验证的临床风险评分(PSI评分和CURB-65评分)对CAP患者死亡风险的预测能力。方法回顾性分析2015年3月至2016年3月天津医科大学总医院呼吸科收治的符合CAP入选标准的150例住院患者的临床资料及预后。根据临床资料计算患者的CURB-65评分及PSI评分。主要研究终点为30天死亡风险。评价PCT及其与风险评分结合对死亡风险的预测能力。结果纳入150例CAP住院患者,其中男77例,女73例,平均年龄(58.4±16.3)岁。12(8%)例患者30天内死亡。死亡患者PCT水平中位数(4.25 ng/ml vs 0.24 ng/ml)及C-反应蛋白(CRP)水平中位数(14.60 mg/dl vs 5.10 mg/dl)均显著增高。两种风险评分更高的患者PCT水平显著增高。PCT与风险评分结合可改善对CAP患者30天死亡风险预测能力。结论入院PCT水平在CAP严重性分层及预后评估中有一定价值,可以较好的鉴别死亡风险较低的患者。与两种风险评分(CURB-65,PSI)相比,PCT预测CAP患者30天死亡风险并无优势,推荐PCT结合风险评分评价CAP患者30天死亡风险。
[Abstract]:Objective to evaluate the value of procalcitonin (PCT) level in the severity stratification and prognosis assessment of community-acquired pneumonia (CPAP), and to evaluate the predictive ability of PCT combined with clinical risk scores (PSI) and CURB-65 scores (CURB-65) in predicting the death risk of CAP patients. Methods the clinical data and prognosis of 150 inpatients admitted to Department of Respiratory of Tianjin Medical University General Hospital from March 2015 to March 2016 were analyzed retrospectively. The CURB-65 and PSI scores were calculated according to the clinical data. The main end point of the study was 30 days of death risk. To evaluate the ability of PCT and its combination with risk score to predict death risk. Results one hundred and fifty patients with CAP died within 30 days, including 77 males and 73 females with an average age of 58.4 卤16.3 years. The median levels of PCT (4.25 ng/ml vs 0.24 ng / ml) and PCT (14.60 mg/dl vs 5.10 mg / dl) were significantly increased in the dead patients. Both higher risk scores significantly increased the level of PCT. The combination of PCT and risk score improved the ability to predict the risk of death in patients with CAP at 30 days. Conclusion admission PCT level has certain value in CAP severity stratification and prognosis evaluation, and can be used to differentiate the patients with lower risk of death. Compared with CURB-65 PSI, PCT has no advantage in predicting the 30-day mortality risk of CAP patients. It is recommended that PCT combined with risk score be used to evaluate the 30-day mortality risk of CAP patients.
【作者单位】：天津医科大学总医院呼吸科;
【分类号】：R563.1

【参考文献】