血小板减少症对社区获得性肺炎的预后分析

发布时间：2018-05-18 21:54

本文选题：社区获得性肺炎 + 血小板减少症　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:早期快速有效的评估社区获得性肺炎(CAP)的严重程度有利于合理使用医疗资源、优化抗感染治疗和改善患者的预后。尽管已有多种方法用于临床评估,本文将研究血小板减少程度对CAP预后的影响。方法:2012年01月到2012年12月期间,对我院各病区因CAP住院的病例资料进行收集整理并回顾性分析。以CURB-65评分对患者进行严重度评分,并以30天病死率为主要终点事件,并评估血小板减少症(血小板低于10~5/μl)与CAP患者预后的关系。结果:共331例CAP患者符合条件入组,平均年龄为65±18岁;中位住院时间为9天(IQR 6-14天),30天内死亡24例(7.3%)。血小板正常或增高患者249例(84.6%);血小板减少患者共51例(15.4%),平均血小板数为73×109/L。血小板减少生存组患者为39例(12.7%),死亡组患者为12例(50%),二者具有统计学差别(P0.001)。血小板减少程度与CAP患者的严重程度相关,通过单因素分析及多元logistic回归分析发现,血小板减少症是CAP患者30天病死率的独立危险因素(OR=5.54,95%CI1.98-15.52,P=0.001)。Kaplan-Meier 生存分析也显示血小板减少症患者具有更低的生存率。结论:血小板减少症是CAP患者30天病死率的独立危险因素,合并血小板减少症的患者具有更低的生存率。联合血小板减少症与CURB-65评分可以更好的判断CAP患者的预后。
[Abstract]:Objective: to evaluate the severity of community-acquired pneumonia (CPAP) quickly and effectively is beneficial to rational use of medical resources, optimization of anti-infective treatment and improvement of prognosis. Although a variety of methods are available for clinical evaluation, we will study the impact of thrombocytopenia on the prognosis of CAP. Methods: from January, 2012 to December, 2012, the data of patients with CAP in our hospital were collected and analyzed retrospectively. The CURB-65 score was used to evaluate the severity of the patients, and the 30-day mortality was taken as the main endpoint event. The relationship between thrombocytopenia (thrombocytopenia) and prognosis of patients with CAP was evaluated. Results: a total of 331 patients with CAP were admitted to the group with an average age of 65 卤18, and the median hospitalization time was 9 days and 24 patients died within 30 days. There were 249 patients with normal or elevated platelet count and 51 patients with thrombocytopenia with an average platelet count of 73 脳 109 / L. There were 39 patients with thrombocytopenia in survival group and 12 patients in death group. There was a statistical difference between the two groups (P 0.001). The degree of thrombocytopenia was correlated with the severity of CAP. Univariate analysis and multivariate logistic regression analysis showed that, Thrombocytopenia is an independent risk factor for 30-day mortality in patients with CAP. The survival rate of patients with thrombocytopenia is lower than that of patients with thrombocytopenia. Conclusion: thrombocytopenia is an independent risk factor for 30-day mortality in patients with CAP. Patients with thrombocytopenia have a lower survival rate. Combined thrombocytopenia and CURB-65 score can better judge the prognosis of CAP patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.1;R558.2

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