新型冠状病毒肺炎患者血液CRP,CREA, ALB,IL-6 水平检测对疾病预后的应用价值分析

目的　探讨性别、年龄以及血液指标联合检测在预测新型冠状病毒肺炎（COVID-19）患者预后的应用价值。方法　选择2020 年2~3 月在泰康同济（武汉）医院的145 例COVID-19 确诊患者，根据出院预后状况分为治愈组（130例）和死亡组（15 例），对两组患者的性别、年龄及血液中淋巴细胞绝对值（LYMPH）、C 反应蛋白（CRP）、肌酸激酶MB 同工酶（CK-MB）、肌酐（CREA）、清蛋白（ALB）、白细胞介素6（IL-6）和降钙素原（PCT）表达水平进行比较。应用多因素logistic 回归分析和受试者工作曲线（ROC 曲线）评价相关检测指标对COVID-19 预后的判断价值。结果　治愈组、死亡组患者性别之间差异无统计学意义（χ ２=0.412，P ＞ 0.05）, 年龄之间差异有统计学意义（t =-4.341,P ＜ 0.05）, LYMPH，CRP，CK-MB，CREA，ALB，IL-6 和PCT 之间差异均有统计学意义（U =97.000~1 907.000, 均P ＜ 0.05），而经多因素logistic 回归分析仅筛选出CRP，CREA，ALB 和IL-6 四项是死亡的独立危险因素。CRP，CREA，ALB，IL-6 以及CRP+CREA+ALB+IL-6 联合检测的ROC 曲线下面积（AUC 值）分别为0.978，0.881，0.950，0.979 和0.988，敏感度分别为100%，86.7%，91.5%，100% 和100%，特异度分别为93.8%，84.6%，86.7%，88.5% 和95.4%。 结论　CRP，CREA，ALB 和IL-6 可以作为COVID-19 患者预后的判断指标，CRP+ALB+CRP+CREA 联合检测能够提高COVID-19 患者预后的评估能力。

Analysis of the Value of Detection of Blood CRP,CREA,ALB and IL-6 Levelin Patients with New Coronavirus Pneumonia to the Prognosis of the Disease

Objective　To explore the value of sex, age and blood indexes in predicting the prognosis of patients withCOVID-19. Methods　A total of 145 patients diagnosed with COVID-19 in Taikang Tongji (Wuhan) Hospital from February toMarch in 2020 were selected. They were divided into cure group (n=130) and death group (n =15) according to the prognosis ofdischarge. The sex, age and the expression levels of lymphocyte absolute value (LYMPH), C-reactive protein (CRP), creatinekinase MB isoenzyme (CK-MB), creatinine (CREA), albumin (ALB), interleukin6 (IL-6) and procalcitonin (PCT) in blood werecompared between the two groups.Multivariate logistic regression analysis and receiver working curve (ROC curve) were used toevaluate the prognostic value of related indexes in COVID-19. Results　The differences in sex between the two groups were notstatistically significant(χ ２=0.412，P>0.05).The differences in ages between the two groups were statistically significant(t =- 4.341, P>0.05). The differences in LYMPH, CRP, CK-MB, CREA, ALB, IL-6 and PCT between the two groups werestatistically significant(U =97.000~1 907.000, all P <0.05). Only CRP, CREA, ALB and IL-6 were independent risk factors ofdeath by multivariate logistic regression analysis.The area under the ROC curve (AUC value) of CRP, CREA, ALB, IL-6 andCRP+CREA+ALB+IL-6 were 0.978，0.881，0.950，0.979 and 0.988，the sensitivity were 100%，86.7%，91.5%，100%and 100%, and the specificity were 93.8%, 84.6%, 86.7%, 88.5% and 95.4%, respectively. Conclusion　CRP, CREA, ALB andIL-6 can be used as prognostic indicators in patients with COVID-19. Combined detection of CRP+ALB+CRP+CREA can improve the ability to evaluate the prognosis of patients with COVID-19.