| 丁伟超,耿润露,周京江,等.红细胞分布宽度、胆碱酯酶、降钙素原对老年重症社区获得性肺炎病人 28 d死亡风险的预测价值[J].安徽医药,2024,28(10):1979-1983. |
| 红细胞分布宽度、胆碱酯酶、降钙素原对老年重症社区获得性肺炎病人 28 d死亡风险的预测价值 |
| Predictive value of red blood cell distribution width, cholinesterase and procalcitonin on 28-day mortality risk of elderly patients with severe community-acquired pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2024.10.015 |
| 中文关键词: 重症社区获得性肺炎(SCAP) 老年人 红细胞分布宽度 胆碱酯酶 降钙素原 预测价值 病死率 |
| 英文关键词: Severe community-acquired pneumonia(SCAP) Elderly Red cell distribution width Cholinesterase Procalcitonin Predictive value Fatality rate |
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| 中文摘要: |
| 目的探讨红细胞分布宽度( RDW)、胆碱酯酶( CHE)、降钙素原( PCT)对老年重症社区获得性肺炎( SCAP)病人 28 d死亡风险的预测价值。方法回顾性分析 2016年 1月至 2021年 12月入住徐州医科大学附属医院的 86例老年 SCAP病人的临床资料。根据 28 d转归情况将病人分为生存组( n=50)与死亡组( n=36)。比较两组病人的一般资料以及入院 24 h内的化验结果。结果死亡组病人的急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)、脓毒症相关性器官功能衰竭评价(SOFA)、白细胞计数、中性粒细胞(NEU)计数、 RDW［(15.61±1.82)%比( 13.89±1.35)%］PCT［14.71(2.37，23.64)μg/L比 0.46(0.19，3.29)μg/L］、 C-反应蛋白( CRP)、白细胞介素 -6(IL-6)、乳酸( LAC)大于生存组，血小板(、PLT)计数、白蛋白( ALB)、 CHE［2 920.00(1 992.00，3 638.00)IU/L比 4 443.00(3 174.00，5 275.00)IU/L］、 pH、氧合指数( PaO2/FiO2)小于生存组( P<0.05)。多因素 logistic回归分析显示 RDW、CHE、PCT是老年 SCAP病人死亡的独立危险因素( P<0.05)。 Spearman相关分析显示， RDW与 PCT呈正相关( r=0.30， P=0.005)RDW与 CHE呈负相关( r=?0.30，P=0.005)。 ROC曲线分析显示 RDW、CHE、PCT预测老年 SCAP病人死亡的 AUC分别为 0.75、0，.71、0.75。联合指标行 ROC曲线分析显示 RDW+CHE、RDW+PCT、CHE+PCT、RDW+CHE+PCT预测老年 SCAP病人死亡的 AUC分别为 0.81、0.87、0.84、0.92，联合指标对老年 SCAP病人死亡的预测能力大于单一指标， RDW+CHE+PCT三项联合指标的预测能力最强。结论 RDW和/或 PCT升高、 CHE降低是老年 SCAP病人死亡的高危因素。而且， RDW、CHE、PCT对老 |
| 英文摘要: |
| Objective To investigate the predictive value of red blood cell distribution width (RDW), cholinesterase (CHE) and procalcitonin (PCT) for 28-day mortality risk in elderly patients with severe community acquired pneumonia (SCAP).Methods The clinical data of 86 elderly patients with SCAP admitted to the Affiliated Hospital of Xuzhou Medical University from January 2016 to De·cember 2021 were retrospectively analyzed. According to 28-day outcome, the patients were divided into survival group (n=50) and death group (n=36). General information and laboratory results within 24 hours after admission were compared between the two groups. Results Acute physiology and chronic health evaluation (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score,white blood cell (WBC) count, neutrophil (NEU) count, RDW [(15.61±1.82)% vs. (13.89±1.35)%], PCT [14.71(2.37,23.64) μg/L vs. 0.46 (0.19,3.29) μg/L], C-reactive protein (CRP), interleukin-6 (IL-6) and lactic acid (LAC) in the death group were higher than those in thesurvival group. Blood platelet(PLT) count, albumin (ALB), CHE [2 920.00 (1 992.00, 3 638.00) IU/L vs. 4 443.00 (3 174.00, 5 275.00) IU/L], pH and oxygenation index (PaO2/FiO2 ) were lower than those in the survival group(P<0.05). Multivariate Logistic regression analysis showed that RDW, CHE and PCT were independent risk factors for death in elderly patients with SCAP (P<0.05). Spearman correlation analysis showed that RDW was positively correlated with PCT (r=0.30, P=0.005), RDW was negatively correlated with CHE (r= ?0.30, P=0.005). ROC curve analysis showed that the AUC of RDW, CHE and PCT for predicting death in elderly patients with SCAPwere 0.75, 0.71 and 0.75, respectively. ROC curve analysis of combined indicators showed that the AUC of RDW+CHE, RDW+PCT,CHE+PCT and RDW+CHE+PCT for predicting death in elderly patients with SCAP were 0.81, 0.87, 0.84 and 0.92, respectively. Thepredictive ability of the combined indicator for death in elderly patients with SCAP was greater than that of the single indicator, andRDW+CHE+PCT had the strongest predictive power.Conclusion Increased RDW and/or PCT and decreased CHE are high risk factors for death in elderly patients with SCAP. In addition, RDW, CHE and PCT have predictive value for 28-day mortality risk in elderly patients with SCAP , and the combined predictive value of each index is higher. |
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