摘要
目的探究胸部CT征象对老年重症肺炎合并肺部感染患者预后转归的预测价值。方法选取2019年2月至2022年2月医院收治的85例老年重症肺炎合并肺部感染患者作为研究组,另纳入30例未发生肺部感染的老年重症肺炎患者作为对照组,所有受试者入院后均接受胸部CT扫描及临床规范化治疗,比较两组CT征象特征。根据研究组患者15 d转归情况将其分为转归组和不良组,收集比较相关生理、病理资料,采用单因素、Logistic回归分析明确影响老年重症肺炎合并肺部感染患者预后转归的危险因素,绘制ROC曲线分析胸部CT征象对老年重症肺炎合并肺部感染患者预后转归的预测价值。结果研究组患者表现斑片影像改变、肺实变、磨玻璃样改变及累及肺叶≥2个占比均显著高于对照组,累及肺叶<2个占比低于对照组,差异有统计学意义(P<0.05)。经单因素、Logistic回归分析,CT征象表达为斑片影像改变、肺实变、磨玻璃样改变、累及肺叶≥2个、高年龄水平、合并糖尿病是影响老年重症肺炎合并肺部感染患者预后转归的危险因素,累及肺叶<2个是影响老年重症肺炎合并肺部感染患者预后转归的保护因素,差异有统计学意义(P<0.05)。经ROC曲线分析,CT征象联合检测预测老年重症肺炎合并肺部感染患者预后转归的AUC为0.735。结论胸部CT检测可较为准确的判断老年重症肺炎合并肺部感染,通过CT征象表达可客观有效的预测老年重症肺炎合并肺部感染的转归情况,为临床制定/优化治疗策略提供借鉴。
Objective To explore the predictive value of chest CT signs in the prognosis of elderly patients with severe pneumonia complicated by pulmonary infection.Methods From February 2019 to February 2022,85 elderly patients with severe pneumonia combined with pulmonary infection were selected as the research group,and 30 elderly patients with severe pneumonia without pulmonary infection were included as the control group.All subjects received chest CT scan and standardized clinical treatment after admission,and the CT signs and characteristics of the two groups were compared.According to the 15-day outcome of the study group,the patients were divided into the outcome group and the poor group,collect and compare relevant physiological and pathological data,use univariate and Logistic regression analysis to identify the risk factors affecting the prognosis of elderly patients with severe pneumonia and pulmonary infection,and draw ROC curve to analyze the prognostic value of chest CT signs in elderly patients with severe pneumonia complicated with pulmonary infection.Results The proportion of patients in the study group with patchy imaging changes,lung consolidation,ground glass changes and involving≥2 lobes were significantly higher than those in the control group,and the proportion of patients involving<2 lobes was lower than that in the control group,the difference is statistically significant(P<0.05).After univariate and Logistic regression analysis,CT signs expressed as patch image changes,lung consolidation,ground glass changes,involving more than 2 lobes,high age level,and diabetes are the risk factors that affect the prognosis of elderly patients with severe pneumonia and pulmonary infection.Involved lung lobe<2 is a protective factor affecting the prognosis of elderly patients with severe pneumonia complicated by pulmonary infection,the difference is statistically significant(P<0.05).According to the ROC curve analysis,the AUC of combined detection of CT signs in predicting the prognosis of elderly patients with severe pneumonia and pulmonary infection was 0.735.Conclusion Chest CT detection can more accurately judge the elderly with severe pneumonia complicated with pulmonary infection,and the expression of CT signs can objectively and effectively predict the outcome of the elderly with severe pneumonia combined with pulmonary infection,which can provide reference for clinical formulation/optimization of treatment strategies.
作者
王书鹏
WANG Shupeng(Department of Imaging,Fangcheng County People’s Hospital,Nanyang Henan 473200,China)
出处
《临床研究》
2023年第12期146-149,共4页
Clinical Research
关键词
CT征象
老年重症肺炎
肺部感染
预后转归
CT signs
severe pneumonia in the elderly
lung infection
prognosis
