摘要
目的观察老年重症肺部感染患者血清降钙素原(PCT)表达水平,探讨其对机械通气撤机结局的预测价值。方法选取重症肺部感染老年患者50例为重症组,轻中重度肺部感染老年患者30例为非重症组,另选取同期体检健康患者30例为对照组。对比3组入院24 h内血清PCT、超敏C反应蛋白(hs-CRP)水平,以及重症组不同病原体感染患者上述指标差异。观察重症组48 h内的撤机结局,分析撤机前血清PCT、hs-CRP和白细胞计数(WBC)水平对撤机结局的预测价值。结果1重症组血清PCT显著高于非重症组和对照组(P<0.05)。2重症组细菌性感染30例,病毒性感染13例,支原体感染7例,重症组细菌性感染患者血清PCT和WBC显著高于病毒性感染和支原体感染患者(P<0.05),hs-CRP比较差异无统计学意义(P>0.05)。3重症组撤机成功39例,撤机失败11例;撤机前血清PCT的ROC曲线下面积为0.812,最佳截点值为0.80 ng/m L,敏感度为82.0%,特异度为76.0%。结论血清PCT可以作为老年重症肺部感染患者的辅助诊断指标,且对患者撤机结局有一定的预测价值。
Objective To investigate the serum level of procalcitonin（ PCT） and its value in predicting weaning outcome of mechanical ventilation in elderly patients with severe pulmonary infection. Methods A total of 50 elderly patients with severe pulmonary infection were selected as the severe group,and 30 elderly patients with mild to moderate pulmonary infection were selected as the non-severe group. Another 30 healthy people aged over 60 were enrolled as the control group. Levels of PCT,high sensitivity C-reactive protein（ hs-CRP） and white blood cell（ WBC） count within 24 h after admission were compared between three groups. The differences in serum levels of PCT,hs-CRP and WBC were also compared in patients with varied infectious pathogens in the severe group. The area under ROC was used to evaluate the predicting value of PCT,hs-CRP levels and WBC for weaning outcome. Results 1The serum PCT level in severe group was significantly higher than that in nonsevere group and control group（ P〈0. 05）. 2 There were 30 cases of bacterial infection,13 cases of viral infection and 7 cases of mycoplasma infection in severe group. The PCT level and WBC were significantly higher in patients with bacterial infection than patients with viral infection and mycoplasma infection（ P〈0. 05）.There was no significant difference in hs-CRP level between patients with varied infectious pathogens（ P〈0. 05）. 3 Out of 50 patients in severe group,39 cases finished weaning and 6 cases failed. The area under curve of PCT was 0. 812,and the optimal cut-off was 0. 80 ng / m L. Sensitivity was 82. 0%,and specificity was 76. 0%. Conclusion Serum PCT can be used as an assistant diagnostic indicator for elderly patients with severe pulmonary infection. It shows potential value in predicting weaning outcome of mechanical ventilation.
出处
《实用临床医药杂志》
CAS
2016年第11期28-31,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(NO:11524340)
关键词
肺部感染
降钙素原
超敏C反应蛋白
白细胞计数
细菌感染
机械通气
撤机
pulmonary infection
procalcitonin
hs-CRP
WBC
bacterial infection
mechanical ventilation
weaning outcome of mechanical ventilation
