摘要
目的 探究重症监护病房(ICU)呼吸机相关性肺炎(VAP)患者血清及支气管肺泡灌洗液(BALF)中白细胞介素-32(IL-32)、降钙素原(PCT)表达及其临床价值。方法 回顾性分析郑州人民医院2017年4月至2019年1月收治的129例机械通气>48 h的ICU患者的临床资料,根据其VAP发生情况分为VAP组(32例)及非VAP组(97例)。记录两组一般资料情况、住院结局(病死率及存活者机械通气时间、ICU停留时间、住院时间),比较两组血清及BALF IL-32、PCT水平差异,并使用受试者工作特征曲线(ROC曲线)评估血清及BALF IL-32、PCT对VAP的早期诊断价值。结果 129例ICU患者中VAP 32例(24.81%),纳入VAP组;无VAP 97例(75.19%),纳入非VAP组。两组一般资料比较差异未见统计学意义(P>0.05)。VAP组住院期间病死7例(21.88%),非VAP组住院期间病死5例(5.15%),VAP组病死率高于非VAP组(χ^2=6.115,P=0.013);且VAP组存活者机械通气时间、ICU停留时间、住院时间均高于非VAP组(P<0.05)。VAP组血清及BALF IL-32、PCT水平均高于非VAP组(P<0.05)。血清及BALF IL-32、PCT对VAP均具有较高早期诊断价值(AUC=0.900、0.909、0.841、0.885,P<0.05),其截断值分别为17.155 pg/ml、1.345 ng/L、22.640 pg/ml、1.940 ng/L。结论 ICU VAP患者具有较高水平血清及BALF IL-32、PCT,临床可根据上述指标诊断早期VAP,以及时治疗,改善患者预后。
Objective To explore the expressions and clinical value of interleukin-32(IL-32)and procalcitonin(PCT)in serum and bronchoalveolar lavage fluid(BALF)in intensive care unit(ICU)patients with ventilator-associated pneumonia(VAP).Methods The clinical data of 129 ICU patients with mechanical ventilation>48 h in Zhengzhou People’s Hospital from April 2017 to January 2019 were retrospectively analyzed.According to the VAP occurrence,they were divided into VAP group(32 cases)and non VAP group(97 cases).The general data and hospitalization outcomes(mortality rate and mechanical ventilation time,ICU stay and hospital stay of survivors)were recorded in the two groups.The levels of IL-32 and PCT in serum and BALF were compared between the two groups.The receiver operating characteristic curve(ROC curve)was used to evaluate the early diagnostic value of IL-32 and PCT in serum and BALF on VAP.Results Of the 129 ICU patients,32 cases(24.81%)with VAP were included in VAP group,and 97 cases(75.19%)without VAP were included in non-VAP group.There were no significant difference in the general data between the two groups(P>0.05).There were 7 cases(21.88%)of death during hospitalization in VAP group and 5 cases(5.15%)of death during hospitalization in non VAP group,and the mortality rate in VAP group was significantly higher than that in non VAP group(χ^2=6.115,P=0.013).The mechanical ventilation time,ICU stay and hospital stay of survivors in VAP group were higher than those in non VAP group(P<0.05).The levels of IL-32 and PCT in serum and BALF in VAP group were higher than those in non VAP group(P<0.05).The IL-32 and PCT in serum and BALF had high early diagnostic value(AUC=0.900,0.909,0.841,0.885,P<0.05),and the cutoff values were 17.155 pg/ml,1.345 ng/L,22.640 pg/ml and 1.940 ng/L respectively.Conclusions ICU patients with VAP have higher levels of IL-32 and PCT in serum and BALF.In clinical,the above indicators can diagnose the early VAP so as to give timely treatment and improve the prognosis.
作者
张浩
朱婉玲
贾金广
Zhang Hao;Zhu Wanling;Jia Jinguang(Department of Respiration,Zhengzhou People’s Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2019年第24期47-50,共4页
Chinese Journal of Practical Medicine
