摘要
目的探讨重症社区获得性肺炎(SCAP)患者血清皮质醇(COR)水平的动态变化及临床意义。方法测定70例重症社区获得性肺炎患者入院后第1、3、5天清晨8:00血清COR水平,同时计算第1天PSI评分,根据预后分为死亡组和存活组。另随机选择同期住院的30例普通社区获得性肺炎(CAP)患者作为对照组并进行统计分析。结果重症肺炎组死亡23例,死亡率32.8%。重症肺炎组PSI评分、COR水平明显高于普通肺炎组,差异有统计学意义。ROC曲线分析显示入院PSI评分、COR水平诊断重症肺炎曲线下面积(AUC)分别为0.886、0.827。血清COR水平随着PSI分级增加而逐渐升高,差异有统计学意义。死亡组存活组患者的血清平均COR水平均呈上升趋势,但死亡组上升更为明显,差异均有统计学意义。结论血清COR水平可以有效评估社区获得性肺炎患者病情的严重程度,其是重症肺炎诊断及预后评估的一个良好指标。
Objective To evaluate the dynamic monitoring of plasma cortisol level in patients with severe community-acquired pneumonia （SCAP） and its clinical significance. Methods The cortisol level in 70 SCAP patients were determined on the 1st, 3rd, and 5th days after admission, and calculated the PSI score on the first day. They were divided into the survival group and the death group according their prognosis. Another 30 cases of non- SCAP hospitalized at the same period were enrolled as the control group. Results 23 cases of the SCAP group died and the mortality was 32. 8%. The first day＇ PSI score and the cortisol level in the SCAP group were significantly higher than those in the non-serious pneumonia group （ P 〈 0. 05 ）. The area under the curve of the PSI score and cortisol in the diagnosis of severe pneumonia were 0. 886 and 0. 827. The mean cortisol level was different significantly among different PSI groups （P 〈 0. 05 ）. The plasma cortisol level in the death group was significantly higher than that in the survival group （P 〈 0. 05）. Conclusion Plasma cortisol level can effectively evaluate the severity of illness in patients with community acquired pneumonia, and it could be useful for the diagnosis and prognosis assessment of SCAP.
出处
《临床肺科杂志》
2016年第3期437-439,共3页
Journal of Clinical Pulmonary Medicine
关键词
皮质醇
社区获得性肺炎
重症
动态变化
cortisol
community acquired pneumonia
severity
dynamic monitoring
