摘要
目的:探索降钙素原清除率对脑卒中后重症肺部感染患者预后的预测效果。方法:选取2016年1月-2018年12月于本院接受治疗的106例脑卒中后重症肺部感染患者为研究对象。按照治疗效果将其分为好转组(n=62)和恶化组(n=44)。于不同时间点抽取患者清晨空腹静脉血液检测降钙素原(PCT)水平并计算降钙素原清除率(PCTc)。采用受试者工作特征曲线分析不同时间点患者PCTc、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)对脑卒中后重症肺部感染患者预后的预测效果。结果:治疗第1、3天,两组的PCT水平比较,差异均无统计学意义(P>0.05);治疗第7、10、14天,恶化组PCT水平均显著高于好转组,差异均有统计学意义(P<0.05)。治疗第3、7、10、14天,恶化组PCTc水平均显著低于好转组,差异均有统计学意义(P<0.05)。好转组APACHEⅡ评分(16.57±3.69)分,恶化组APACHEⅡ评分(20.48±4.15)分,两组比较,差异有统计学意义(P<0.05)。治疗第14天的PCTc对脑卒中后重症肺部感染患者预后的预测效果最好,灵敏度为99.2%,特异度为88.5%。结论:脑卒中后重症肺部感染患者发病后PCT水平较高,且与病情恶化具有相关性,PCTc能够作为临床一项初步预测脑卒中后重症肺部感染患者预后的指标,预测效果良好。
Objective:To explore the predictive effect of procalcitonin clearance on the prognosis of patients with severe pulmonary infection after stroke.Method:A total of 106 patients with severe pulmonary infection after stroke who received treatment in our hospital from January 2016 to December 2018 were selected as the research subjects.According to the treatment effect,they were divided into improved group(n=62)and worsening group(n=44).Fasting venous blood samples were collected at different time points in the morning to detect PCT levels and PCTc clearance rate was calculated.The predictive effects of PCTc,acute physiology and chronic health scoreⅡ(APACHEⅡ)at different time points on the prognosis of patients with severe pulmonary infection after stroke were analyzed by receiver operating characteristic curve.Result:There were no significant differences in PCT levels between the two groups on the 1st and 3rd day of treatment(P>0.05).On the 7th,10th and 14th day of treatment,the PCT level in the worsening group were significantly higher than those in the improving group,with statistical significance(P<0.05).On day 3,7,10 and 14 of treatment,PCTc level in the worsening group were significantly lower than those in the improving group,with statistical significance(P<0.05).Improved group of APACHEⅡscore of(16.57±3.69)points,worsening group APACHEⅡscore of(20.48±4.15)points,comparing the two groups,the difference was statistically significant(P<0.05).PCTc on the 14th day of treatment was the best predictor of prognosis in patients with severe pulmonary infection after stroke,with a sensitivity of 99.2%and a specificity of 88.5%.Conclusion:PCT level is high in patients with severe pulmonary infection after stroke,and it is correlated with the deterioration of the disease.PCTc can be used as a preliminary indicator to predict the prognosis of patients with severe pulmonary infection after stroke,and the prediction effect is good.
作者
袁明贤
YUAN Mingxian(The Second People’s Hospital of Guangdong Province,Guangzhou 510317,China)
出处
《中国医学创新》
CAS
2021年第4期140-144,共5页
Medical Innovation of China
关键词
降钙素原清除率
脑卒中
重症
肺部感染
预后
Procalcitonin clearance rate
Stroke
Severe disease
Pulmonary infection
Prognosis
