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| 降钙素原、D-二聚体和脑钠肽在老年医院获得性肺炎诊断、病情判断及预后评估中的应用分析 |
| Analysis of procalcitionin, D-dimer and brain natriuretic peptide applied in diagnosis, severity determination and prognosis evaluation of elder patients with hospital acquired pneumonia |
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| DOI：10.3969/j.issn.1007-8134.2021.05.017 |
| 中文关键词: 医院获得性肺炎 降钙素原 脑钠肽 D-二聚体 诊断 预后评估 |
| 英文关键词: hospital acquired pneumonia procalcitionin brain natriuretic peptide D-dimer diagnosis prognosis evaluation |
| 基金项目:河南省医学科技攻关计划项目（182102310233） |
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| 中文摘要: |
| 目的 探讨血浆降钙素原（procalcitonin, PCT）、D-二聚体（D-dimer, D-D）和脑钠肽（brain natriuretic peptide, BNP）在老年医院获得性肺炎（hospital acquired pneumonia, HAP）诊断、病情判断及预后评估中的应用。方法 选取在我院治疗的老年HAP患者96例（HAP组）和50例老年健康体检者（健康对照组）为研究对象，根据PSI评分将HAP患者分为低危组（39例）、中危组（35例）和高危组（22例）；HAP患者根据28 d生存情况分为死亡组（13例）和生存组（83例），检测和比较各组PCT、BNP和D-D水平。结果 HAP组治疗前PCT、BNP和D-D水平均显著高于健康对照组（P均＜0.05）；PCT、BNP和D-D 诊断HAP的AUC分别为0.899、0.814和0.759；不同病情严重程度分组患者治疗前PCT、BNP、D-D水平及PSI评分比较差异均有统计学意义（P均＜0.05），高危组治疗前PCT、BNP、D-D水平及PSI评分均显著高于低危组和中危组（P均＜0.05），中危组治疗前PCT、BNP、D-D水平及PSI评分均显著高于低危组（P均＜0.05）；死亡组治疗前PCT、BNP和D-D水平及PSI评分均显著高于生存组（P均＜0.05）；生存组治疗后PCT、BNP和D-D水平均低于治疗前（P均＜0.05），生存组患者D-D水平与PSI评分呈正相关（rD-D=0.647，P＜0.001）。结论 老年HAP患者PCT、BNP和D-D水平异常升高，并与肺炎严重程度正相关，PCT、BNP和D-D水平可反映老年HAP患者病情严重程度和预后情况。 |
| 英文摘要: |
| Objective To explore the application of plasma procalcitionin (PCT), D-dimer (D-D) and brain natriuretic peptide (BNP) in the diagnosis, severity determination and prognosis evaluation of elder patients with hospital acquired pneumonia (HAP). Methods Ninety-six elder patients with HAP treated in our hospital (HAP group) and elder subjects for healthy examination (health control group) were selected as the study object. According to the PSI score, HAP patients were divided into low-risk group (39 cases), middle-risk group (35 cases) and high-risk group (22 cases). According to the 28-day survival condition, the HAP patients were divided into death group (13 cases) and survival group (83 cases). The levels of plasma PCT, D-D and BNP in each group were detected and compared. Results The levels of PCT, BNP and D-D in HAP group were significantly higher than those in healthy control group before treatment (P＜0.05). The AUC of PCT, BNP and D-D in diagnosing HAP were 0.899, 0.814 and 0.759, respectively. There were significant differences in PCT, BNP, D-D levels and PSI score before treatment in patients with different severities (P＜0.05). The levels of PCT, BNP, D-D and PSI score in high-risk group were significantly higher than those in middle-risk group and low-risk group before treatment (P＜0.05), and the levels of PCT, BNP, D-D and PSI score in middle-risk group were significantly higher than those in low-risk group before treatment (P＜0.05). The levels of plasma PCT, BNP, D-D and PSI score in death group were significantly higher than those in survival group (P＜0.05). After treatment, the levels of plasma PCT, BNP and D-D in survival group were significant lower than those before treatment (P＜0.05), and the levels of D-D in survival patients were positively correlated with PSI score (rD-D=0.647, P＜0.001). Conclusions The levels of plasma PCT, BNP, D-D in elder patients with HAP increase abnormally, and they are positively correlated with the severity of pneumonia. The levels of PCT, BNP and D-D can reflect the severity and prognosis condition of elder HAP patients. |
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