摘要
目的探讨急性卒中患者细菌性肺炎危险因素,早期血清PCT对细菌性肺炎和脓毒症分级的预测价值。方法选取我院2015年3月—2017年8月收治的急性卒中患者100例,根据是否发生细菌性肺炎分为卒中相关性肺炎(SAP)组68例,无感染组32例;比较2组的临床资料并做logistic回归分析。采用ROC曲线分析血清降钙素原(PCT)对SAP和脓毒症分级的预测价值。结果 SAP组年龄、GCS评分≤8分、PCT≥0. 05 ng/ml、FPG水平均高于无感染组(P <0. 05)。GCS评分≤8分、PCT≥0. 05 ng/ml、FPG≥6. 1mmol/L是SAP的独立危险因素(P <0. 05)。脓毒症组、严重脓毒症组血清PCT水平均高于局部感染组,且严重脓毒症组高于脓毒症组(P <0. 05)。在对SAP诊断预测价值中,当PCT水平≥0. 070 ng/ml时,特异度为73. 90%,敏感度为84. 10%,ROC曲线下面积为0. 864(P <0. 05)。结论 GCS评分≤8分、PCT≥0. 05 ng/ml、FPG≥6. 1 mmol/L是急性卒中发生细菌性肺炎的独立危险因素,PCT水平对于SAP诊断及脓毒症分级均有较好的预测价值。
Objective To investigate values of risk factors for bacterial pneumonia and early serum procalcitonin(PCT)in prediction of bacterial pneumonia and sepsis classifications in patients with acute stroke.Methods A total of 100 patients with acute stroke admitted during March 2015 and August 2017 was retrospectively analyzed,and the patients were divided into stroke-associated pneumonia(SAP)group(n=68)and non infection group(n=32)according to whether or not having bacterial pneumonia,In two groups,clinical data was compared,and logistic regression analysis was performed.Receiver operating curve(ROC)was used to analyze value of serum PCT levels in prediction of SAP and sepsis classifications.Results Glasgow coma scale(GCS)score equal or less than 8 points,PCT equal or more than 0.05 ng/mL and fasting plasma glucose(FPG)equal or more than 6.1 mmol/L were independent risk factors for SAP in patients with acute stroke(P<0.05).Levels of serum PCT in sepsis and severe sepsis groups were significantly higher than that in local infection group,and the level in severe sepsis group was significantly higher than that in sepsis group(P<0.05).In prediction and diagnosis of SAP value,specificity and sensitivity were 73.90%and 84.10%respectively,and the area under ROC was 0.864 when PCT level was equal or more than 0.070 ng/ml(P<0.05).Conclusion Glasgow coma scale(GCS)score equal or less than 8 points,PCT equal or more than 0.05 ng/mL and fasting plasma glucose(FPG)equal or more than 6.1 mmol/L are independent risk factors for bacterial pneumonia in patients with acute stroke,and PCT level has good predictive value for SAP diagnosis and sepsis classification.
作者
徐永兰
吴红玲
唐瑞芳
XU Yong-lan;WU Hong-ling;TANG Rui-fang(Department of Rehabilitation,Affiliated Hospital of Hubei University of Arts and ScienceXiangyang Central Hospital,Xiangyang,Hubei 441000,China)
出处
《解放军医药杂志》
CAS
2019年第2期68-71,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
湖北省自然科学基金资助项目(2011CDB318)
