摘要
目的 探讨凝溶胶蛋白联合CURB-65评分对老年社区获得性重症肺炎近期（28 d）预后的评估价值.方法 研究对象为2011-01～2011-12来北京医院急诊科就诊的老年社区获得性重症肺炎患者29例,入院24 h内检测血浆凝溶胶蛋白值,并进行CURB-65评分及APACHEⅡ评分,根据28 d预后将患者分为存活组和死亡组,对两组的凝溶胶蛋白水平、CURB-65评分及APACHEⅡ评分进行比较,并将凝溶胶蛋白与CURB-65评分联合对预后进行评估.结果 存活组13例,死亡组16例,两组凝溶胶蛋白值为[（26.19±6.95） mg/L与（14.47±5.95） mg/L,P〈0.05）],CURB-65评分为[（2.30±0.70） 分与（3.45±1.14） 分,P〈0.05）],APACHEⅡ评分为[（20.21±4.04） 分与（30.46±6.54） 分,P〈0.05）].凝溶胶蛋白与患者预后呈负相关,APACHEⅡ评分、CURB-65评分与患者预后呈正相关,凝溶胶蛋白联合CURB-65评分对近期不良预后的评估更为准确,并与APACHEⅡ评分具有一致性.结论 凝溶胶蛋白联合CURB-65评分可以对老年社区获得性重症肺炎患者预后进行评估,并可能替代APACHEⅡ评分.
Objective To investigate the value of gelsolin combined with CURB -65 score for predicting the prognosis of emergency aged patients with community - acquired severe pneumonia. Methods 29 aged patients with severe community- acquired pneumonia admitted to emergency department of Beijing hospital were studied and followed - up. The plasma gelsolin was detected within 24 hours of admission, and the patients were graded by CURB - 65 score and APACHE Ⅱ score. According to the prognosis at the 28 day, patients were divided into survival group and death group. Two groups of gelsolin level, CURB - 65 score and APACHE Ⅱ score were compared, and prognosis was evaluated by gelsolin and CURB -65 score. Results 13 cases were survival, and 16 cases were dead. Gelsolin values of the two groups were （26. 19 ± 6.95 ） mg/L and （ 14.47 ± 5.95 ） mg/L, respectively （ P 〈 0.05 ）. CURB - 65 score were （ 2.30 ± O. 70 ） and （ 3.45± 1.14 ） （ P 〈 0.05 ）, and APACHE I1 sore were（20. 21 ± 4.04） and（30. 46 ± 6.54） （P 〈 0.05）, respectively. There was a negative correlation between gelsolin and prognosis of patients. CURB - 65 score and APACHE II score were positively correlated with the prognosis of patients. The accuracy in predicting the prognosis was better when gelsolin was combined with CURB -65 score compared to gelsolin or CURB -65 alone, and was consistent with APACHE I1 score. Conclusion CURB - 65 score could replace APACHE Ⅱ score, and be applied to evaluate the prognosis of aged patients with severe community acquired pneumonia.
出处
《中国急救医学》
CAS
CSCD
北大核心
2013年第9期805-808,共4页
Chinese Journal of Critical Care Medicine
