摘要
目的评估社区获得性肺炎(CAP)的严重程度并分析其危险因素。方法回顾性分析2016年1月至2019年12月在廊坊市人民医院收治的CAP患者300例。按其病情严重程度分为重症组120例、普通组180例,另选同期体检健康志愿者120例为对照组。比较3组C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)水平,分析CAP严重程度与CRP、PCT、TNF-α、NLR、PLR表达的相关性;对CAP患者进行28 d生存率随访,Logistic回归分析CAP患者死亡的危险因素。结果3组CRP、PCT、TNF-α、NLR、PLR水平比较重症组>普通组>对照组,差异有统计学意义(P值均<0.05)。相关性分析显示,CURB-65评分与CRP、PCT、TNF-α、NLR、PLR水平呈正相关(r值分别为5.476、4.385、3.742、5.645、6.541,P<0.05)。logistic回归分析结果显示年龄≥65岁、CURB-65评分≥3分、合并肾功能不全、入院前未使用抗生素、呼吸性酸中毒、NLR≥10.09、PLR≥171.61是CAP患者死亡的危险因素。结论CAP的严重程度与CRP、PCT、TNF-α、NLR、PLR呈正相关,年龄、CURB-65评分、肾功能不全、入院前抗生素使用、呼吸性酸中毒及NLR、PLR水平均对预测患者预后有重要意义。
Objective To assess the severity of community-acquired pneumonia(CAP)and risks.Methods A retrospective analysis was performed in 300 CAP patients admitted to Langfang People′s Hospital from January 2016 to December 2019.According to CAP severity,the patients were divided into severe group(n=120)and normal group(n=180),and 120 healthy volunteers from health check during the same period served as control group.C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factorα(TNF-α),neutrophil-to-lymphocyte ratio(NLR),and platelet to-lymphocyte ratio(PLR)were compared among three groups.CAP severity was analyzed for the items.The 28-day survival rate of CAP patients was followed up,and the risks of death in CAP patients were analyzed with logistic regression.Results CRP,PCT,TNF-α,NLR,and PLR increased in order severe group>normal group>control group,and the difference were statistically significant(all P<0.05).CURB-65 score positively correlated with CRP,PCT,TNF-α,NLR,and PLR levels(r values are 5.476,4.385,3.742,5.645,6.541,respectively,all P<0.05).Logistic regression analysis showed age≥65 years old,CURB-65 score≥3 points,combined with renal insufficiency,no antibiotics before admission,respiratory acidosis,NLR≥10.09,PLR≥171.61 were risk factors for death in CAP patients.Conclusions The severity of CAP is positively correlated with CRP,PCT,TNF-α,NLR,and PLR.Age,CURB-65 score,renal insufficiency,antibiotics administration before admission,respiratory acidosis,and NLR and PLR can predict the prognosis of the patients.
作者
门猛
苗雅娇
刘则林
Men Meng;Miao Yajiao;Liu Zelin(Department of Infection,Langfang People′s Hospital,Langfang 065000,China)
出处
《国际呼吸杂志》
2021年第23期1795-1800,共6页
International Journal of Respiration
基金
廊坊市科学技术研究与发展计划自筹经费项目(2020013080)。
