摘要
目的探讨降钙素原(PCT)、简化临床肺部感染评分(CPIS)对呼吸机相关性肺炎(VAP)患者的预后评估。方法对2009年1月-2010年5月入住ICU的VAP患者48例进行回顾性分析,分别记录VAP组第1、5天,转出或死亡前最后一次的PCT、CPIS、APACHEⅡ评分;根据预后将患者分为生存组和死亡组,通过统计分析对两组的预后进行比较。结果 VAP患者第5天死亡组的CPIS水平(8.35±4.36)显著高于存活组(5.58±3.12),转出或死亡前最后一次死亡组的CPIS水平(9.27±3.04)显著高于存活组(3.35±2.20);VAP患者第5天死亡组的PCT水平(6.3±1.6)mg/L显著高于存活组(3.4±1.6)mg/L,转出或死亡前最后一次死亡组的PCT水平(8.1±3.4)mg/L显著高于存活组(1.6±1.1)mg/L;CPIS和PCT与APACHEⅡ评分呈正相关(r=0.658,P<0.01和r=0.702,P<0.01)。结论动态监测PCT和CPIS对于评价VAP预后具有重要的临床指导意义,CPIS、PCT持续高水平提示病情危重。
OBJECTIVE To evaluate the value of procalcitonin（PCT） and clinical pulmonary infection score（CPIS）in the evaluation of prognosis of the patients with ventilator-associated pneumonia（VAP）.METHODS The clinical data of 48 cases with VAP in the ICU were retrospectively analyzed,the PCT,CPIS and APACHEⅡ was calculated on the 1st,5th day of the enrollment,and the last day before the patients died or were transferred in the VAP group;the patients were divided into the death group and the survival group according to the prognosis,and the prognosis of the two groups was compared through statistical analysis.RESULTS The CPIS level of the death group（8.35±4.36） on the 5th day was significantly higher than that of the survival group（5.58±3.12）;the CPIS level of the death group（9.27±3.0） on the last day before the patients died or were transferred out was significantly higher than that of the survival group（3.35±2.20）;the PCT level of the death group（6.3±1.6 mg/L） on the 5th day was significantly higher than that of the survival group（1.6±1.1 mg/L）;the PCT level of the death group（8.1±3.4 mg/L） on the last day before the patients died or were transferred was significantly higher than that of the survival group（1.6±1.1 mg/L）;the CPIS was positively correlated with PCT and APACHEⅡ score（r=0.658,P0.01 and r=0.702,P0.01）.CONCLUSION Dynamic monitoring of PCT and CPIS had significant clinical significance in evaluation of the prognosis of VAP,the constant high level of CPIS or PCT indicates the severity of the disease.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第22期4937-4939,共3页
Chinese Journal of Nosocomiology
关键词
降钙素原
简化临床肺部感染评分
呼吸机相关性肺炎
预后
Procalcitonin
Clinical pulmonary infection score
Ventilator-associated pneumonia
Prognosis
