论文部分内容阅读
目的探讨降钙素原(PCT)对老年重症社区获得性肺炎(CAP)严重程度的评估价值。方法选取2013年1月至2015年6月廊坊市第四人民医院内二科老年重症CAP患者105例,根据急性生理和慢性健康状况(APACHEⅡ)评分将患者分为高危组(≥20分)46例与低危组(<20分)59例。根据患者入院后28 d是否死亡分为死亡组(n=32)与存活组(n=73)。在治疗前测定体温、白细胞、红细胞沉降率、PCT水平,同时行APACHEⅡ评分。结果高危组血清PCT水平和APACHEⅡ评分均高于低危组,差异有统计学意义(P<0.05);死亡组血清PCT水平和APACHEⅡ评分均高于存活组,差异有统计学意义(P<0.01)。APACHEⅡ评分与PCT水平呈正相关(r=0.503,P<0.01),而与体温、WBC、中性粒细胞所占比例、ESR无相关性(P>0.05)。结论血清PCT水平与APACHEⅡ评分有较强的相关性,PCT与APACHEⅡ评分结合综合分析,有助于对老年重症肺炎的病情程度和预后的判断。
Objective To evaluate the value of procalcitonin (PCT) in evaluating the severity of severe community-acquired pneumonia (CAP) in the elderly. Methods From January 2013 to June 2015, 105 elderly patients with severe CAP in the second hospital of the Fourth People’s Hospital of Langfang City were enrolled. Patients were divided into high risk group (≥20 points) 46 according to acute physiology and chronic health status (APACHEⅡ) Cases and low risk group (<20 points) 59 cases. Patients were divided into death group (n = 32) and survival group (n = 73) according to whether the patient died on the 28th day after admission. Before treatment, body temperature, white blood cells, erythrocyte sedimentation rate and PCT level were measured, and APACHEⅡscore was also performed. Results The levels of PCT and APACHEⅡ in high risk group were significantly higher than those in low risk group (P <0.05). The levels of serum PCT and APACHEⅡ in death group were significantly higher than those in surviving group (P <0.01) ). There was a positive correlation between APACHE Ⅱ score and PCT level (r = 0.503, P <0.01), but no correlation with body temperature, WBC, neutrophil percentage and ESR (P> 0.05). Conclusions There is a strong correlation between serum PCT level and APACHEⅡscore. The combination of PCT and APACHEⅡscores can help to judge the severity and prognosis of severe pneumonia in the elderly.