摘要
目的 观察社区获得性肺炎致急性呼吸窘迫综合征（ARDS）患者血清降钙素原水平变化与预后的关系。方法 前瞻性观测46例社区获得性肺炎致ARDS患者在入选时、24小时及72小时的血清降钙素原水平变化,分析其与ARDS患者预后的关系。结果 46例ARDS患者中入选14天时生存27例（占58.7%）,死亡19例（占41.3%）;入选时、入选24小时及72小时死亡组血清降钙素原水平都显著高于生存组,差异都有统计学意义（P分别为0.028、0.047和0.019）。多变量Cox回归模型分析发现,如入选时血清PCT〉3.9 ng/L,与ARDS患者死亡显著相关,危险比3.68,95%可信区间（0.66-5.21）,差异有统计学意义（P=0.044）。结论 社区获得性肺炎致ARDS患者如发病72小时内血清PCT水平显著增高,则预示ARDS患者预后不佳。
Objective To explore the clinical value of serum procalcitonin （PCT） in predicting the outcome of patients with acute respiratory distress syndrome （ ARDS） caused by severe community-acquired pneumonia. Methods A prospective observational study was conducted from January, 2013 to December, 2014. The level of se-rum PCT was analyzed at study baseline, 24h and 72h after enrollment. Results Among the 46 patients with ARDS caused by community-acquired pneumonia, 27 （58. 7% ） patients were alive on Day 14 and 19 （41. 3% ） died. The level of serum procalcitonin was obviously higher in the death group than in the survival group at any time point （P =0. 028, 0. 047 and 0. 019 respectively）. Multivariate Cox regression analysis showed serum procalcitonin 〉 3. 9 ng/ L was significant in predicting the mortality （P = 0. 044）. The risk ratio was 3. 68. Conclusion The high serum pro-calcitonin level within 72h of ARDS onset predicts the bad prognosis of patients with ARDS caused by severe commu-nity-acquired pneumonia.
出处
《临床肺科杂志》
2015年第8期1441-1443,共3页
Journal of Clinical Pulmonary Medicine
关键词
降钙素原
肺炎严重指数
急性呼吸窘迫综合征
社区获得性肺炎
procalcitonin
pneumonia severity index
acute respiratory distress syndrome
community-ac-quired pneumonia
