摘要
目的:探讨重症监护室(ICU)重症社区获得性肺炎(SCAP)老年患者血小板、凝血功能指标及血清可溶性髓样细胞触发受体-1(sTREM-1)变化及临床意义。方法:选取我院2019年1月至2020年1月ICU收治的94例SCAP患者为SCAP组,根据28 d内生存情况将SCAP患者分为死亡组(n=18)与存活组(n=76)。比较两组PLT、凝血功能指标及血清sTREM-1水平,多因素逐步Logistic回归分析SCAP患者预后不良影响因素,ROC曲线分析PLT、凝血功能指标及血清sTREM-1水平对老年SCAP患者不良预后的预测价值。结果:死亡组PLT明显低于存活组,凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、D-Dimer、sTREM-1水平明显高于存活组(P<0.05)。多因素逐步Logistic回归分析显示,机械通气时间>15 d和高PT、APTT、FIB、D-Dimer、sTREM-1水平为SCAP患者预后不良危险因素,高氧合指数、PLT为保护因素(P<0.05)。ROC曲线显示,PLT+PT+APTT+FIB+D-Dimer+sTREM-1联合预测老年SCAP患者不良预后的曲线下面积(AUC)明显大于各指标单独预测(P<0.05)。结论:预后不良老年SCAP患者PLT明显降低,PT、APTT、FIB、D-Dimer、sTREM-1水平明显提升,联合检测能提升不良预后预测价值。
Objective: To investigate the changes and clinical significance of platelet, coagulation function and serum soluble myeloid cell trigger receptor-1(sTREM-1) in patients with severe community-acquired pneumonia(SCAP) over 60 years old in the intensive care unit(ICU). Methods: A total of 94 SCAP patients admitted to our hospital′s ICU(January 2019 to January 2020) were selected as the SCAP group. SCAP patients were divided into death group(n=18) and survival group(n=76). Compare the two groups of platelet count(PLT), coagulation function indexes and serum sTREM-1 levels, multivariate stepwise Logistic regression analysis of factors affecting the prognosis of SCAP patients, the ROC curve analyzes the predictive value of PLT, coagulation function indexes and serum sTREM-1 levels in the poor prognosis of elderly SCAP patients. Results: The PLT of the death group was significantly lower than that of the survival group, and the prothrombin time(PT), activated partial thrombin time(APTT), fibrinogen(FIB), D-Dimer, and sTREM-1 levels were significantly higher than those of the survival group(P<0.05). multivariate stepwise logistic regression analysis showed that mechanical ventilation time>15 days and high PT, APTT, FIB, DD, sTREM-1 levels were independent risk factors for poor prognosis in SCAP patients, and high oxygenation index and PLT were independent protective factors(P<0.05). The ROC curve showed that the area under the curve(AUC) of the combination of PLT+PT+APTT+FIB+D-Dimer+sTREM-1 predicting the poor prognosis of elderly SCAP patients was significantly greater than that predicted by each index alone(P<0.05).
作者
关雨
胡占升
杨兴官
李男
GUAN Yu;HU Zhansheng;YANG Xingguan;LI Nan(Department of Critical Care Medicine,The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,China)
出处
《心肺血管病杂志》
CAS
2021年第8期818-822,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
重症社区获得性肺炎
血小板
凝血功能
可溶性髓样细胞触发受体-1
老年
Severe community-acquired pneumonia
Platelets
Coagulation function
Soluble triggering receptor expressed on myeloid cell-1
Elderly
