营养及炎性指标对不同年龄段重症下呼吸道感染患者近期预后的评估价值研究

发布时间：2018-08-22 20:20

【摘要】：目的探讨营养及炎性指标对不同年龄段重症下呼吸道感染患者近期预后的评估价值。方法选取2011年10月—2013年2月中国人民解放军成都军区总医院呼吸重症监护病区(RICU)收治的重症下呼吸道感染患者170例,检测患者入院时血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、清蛋白(Alb)、前清蛋白(PA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿素氮、肌酐、血红蛋白(Hb)水平和淋巴细胞计数(LY),运用受试者工作特征(ROC)曲线计算曲线下面积(AUC),分析其对患者25 d死亡的预测价值。结果年龄预测25 d内死亡的ROC曲线分析结果显示:当年龄为66岁时,灵敏度为90.5%、特异度为37.3%、约登指数为28.2%。103例年龄≥66岁患者20例25 d内死亡,ROC曲线分析结果显示:PCT的AUC为0.786,其后依次为尿素氮、Alb、hs-CRP、PA、LY、LDL-C、肌酐、HDL-C、Hb、TC、TG,AUC均0.500。25 d死亡组与非死亡组的PCT、尿素氮、Alb及hs-CRP间的AUC差异有统计学意义(P0.05),具有独立预测价值。67例年龄66岁患者8例25 d内死亡,ROC曲线分析结果显示:LDL-C的AUC为0.732,LY的AUC为0.722,其后依次为Alb、PCT、hs-CRP、TC、PA、TG、HDL-C、Hb、肌酐、尿素氮,AUC均0.500。25 d死亡组与非死亡组的LDL-C和LY的AUC差异有统计学意义(P0.05),具有独立预测价值。结论炎性指标预测年龄≥66岁的重症下呼吸道感染患者近期预后的价值较高;营养指标预测年龄66岁患者近期预后的价值较高。不同疾病状态、不同年龄患者应选择灵敏度高的预测指标。
[Abstract]:Objective to evaluate the prognostic value of nutritional and inflammatory markers in patients with severe lower respiratory tract infection in different age groups. Methods 170 patients with severe lower respiratory tract infection were selected from October 2011 to February 2013 in (RICU) of Chengdu military region Hospital of Chinese PLA. Serum procalcitonin proto (PCT), hypersensitive C-reactive protein (hs-CRP), serum albumin (Alb), prealbumin (PA), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea nitrogen, creatinine were detected on admission. Hemoglobin (Hb) level and lymphocyte count (LY), were used to calculate the area under the curve by using the (ROC) curve of the subjects' operating characteristics. The value of (AUC), analysis in predicting the death of patients at 25 days was analyzed. Results the ROC curve analysis of age prediction within 25 days showed that when the age was 66 years old, The sensitivity was 90.5 and the specificity was 37.3. The Yorden index was 28.2.103 patients aged 鈮，

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