| 刘建英,陈学兵,张练,等.C反应蛋白、血浆白蛋白联合急性生理和慢性健康评分对院内肺部感染重症病人预后价值[J].安徽医药,2021,25(5):927-930. |
| C反应蛋白、血浆白蛋白联合急性生理和慢性健康评分对院内肺部感染重症病人预后价值 |
| Prognostic value of C-reactive protein, plasma albumin and Apache Ⅱ score with nosocomial pulmonary infection |
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| DOI：10.3969/j.issn.1009-6469.2021.05.020 |
| 中文关键词: 交叉感染 肺部感染 预后 C反应蛋白 血浆白蛋白 急性生理和慢性健康评分 |
| 英文关键词: Cross infection Pulmonary infection Prognosis C-reactive protein Plasma albumin Acute physiology and chronic health score |
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| 中文摘要: |
| 目的研究 C反应蛋白( CRP)、血浆白蛋白( ALB)水平联合急性生理和慢性健康评分( APACHEⅡ)用于判断重症医学科(ICU)肺部感染重症病人预后价值。方法选取 2017年 2月至 2019年 5月德阳市人民医院 ICU发生院内肺部感染重症病人 139例，其中 114例存活病人为存活组、 25例死亡病人为死亡组；病人均于发生肺部感染后 24 h行血清 CRP、ALB检测及 APACHEⅡ评分，比较两组血清 CRP、ALB水平及 APACHE Ⅱ评分差异，并分析肺部感染后 28 d内死亡的危险因素，并进一步绘制 ROC曲线，分析肺部感染后 24 h血清 CRP、ALB及 APACHE Ⅱ评分单独及联合评估对感染后 28 d内死亡的预测价值。结果两组性别、年龄、原发病、合并症等差异无统计学意义(P>0.05)死亡组多器官功能障碍综合征( MODS)所占比例明显高于存活组，差异有统计学意义(68.00%比 43.86%，P<0.05)。死亡组肺部，感染后 24 h血清 CRP水平［(93.41±33.32)mg/L比( 54.55±17.64)mg/L］、 APACHEⅡ评分［( 26.84±7.17)分比( 21.26±4.91)分］均高于存活组， ALB水平低于存活组［( 27.39±4.81)g/L比(30.56±5.49)g/L］差异有统计学意义( P<0.05)。 logistic逐步回归分析显示，血清 CRP、ALB水平及 APACHEⅡ评分均是 ICU肺d内病死的独立危险因素( P<0.05)。血清 CRP、ALB水平、 APACHEⅡ评分单独预测及三者联合预测 ICU肺部感染重症病人28，部感染的重症病人感染后 28 d内死亡的 AUC分别为 0.841、0.652、0.736、0.906，三者联合的预测效能更高、敏感度及特异度更加均衡。结论重症病人肺部院内感染后行 CRP、ALB水平检测联合 APACHEⅡ评分，有助于早期对病人预后进行评估。 |
| 英文摘要: |
| Objective To study the prognostic value of C-reactive protein (CRP), plasma albumin (ALB) combined with acute physiology and chronic health score (APACHE Ⅱ) in patients with severe pulmonary infection in ICU.Methods From February 2017 tomay 2019,139 patients with severe pulmonary infection in the ICU of Deyang people′s hospital were selected, including 114 patients inthe survival group and 25 patients in the death group. Patients with pulmonary infection after 24 h lines of serum CRP, propagated detection and APACHE Ⅱ score, compared two groups of patients serum level of CRP, propagated and APACHE Ⅱ score differences,and analyze the lung infection within 28 d after death risk factors, and further to draw ROC curve analysis of pulmonary infection after24 h of serum CRP, propagated and APACHE Ⅱ score alone and joint assessment of the predictive value of death within 28 d after in‐fection.Results There was no statistically significant difference between the two groups in gender, age, primary disease and complications (P>0.05).The proportion of MODS in the death group was significantly higher than that in the survival group, and the differencewas statistically significant (68.00% vs. 43.86%,P<0.05).24 h after death group of patients with lung infection serum CRP level[(93.41± 33.32)mg/L vs. (54.55±17.64)mg/L], the APACHE Ⅱ score[(26.84±7.17) vs. (21.26±4.91)] were higher than in survival group, propagated level is lower than the survival group[(27.39±4.81)g/L vs. (30.56±5.49)g/L], the difference was statistically significant (P<0.05).logistic stepwise regression analysis showed that the serum level of CRP, propagated and APACHE Ⅱ scores are all ICU patients with pulmonary infection in severe illness within 28 d independent risk factors (P<0.05).Serum level of CRP, propagated, APACHE Ⅱ scorepredict single and combined forecast ICU patients with pulmonary infection of severe infection after the AUC of death within 28 d were0.841, 0.652, 0.736, 0.906, and the combined prediction efficiency is higher, the sensitivity of the forecast and specific degrees morebalanced.Conclusion The detection of CRP and ALB combined with Apache Ⅱ score after pulmonary nosocomial infection in severepatients is helpful to evaluate the prognosis of patients in the early stage. |
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