高血压脑出血合并肺部感染危险因素及和肽素诊断价值

目的分析高血压脑出血合并肺部感染危险因素及和肽素诊断价值。方法选取2017年7月-2019年5月华中科技大学同济医学院附属协和医院收治的150例高血压脑出血患者,根据是否合并肺部感染分为感染组(n=64)和未感染组(n=85)。采用多因素Logistic回归分析高血压脑出血合并肺部感染的危险因素,并分析血清和肽素、PCT、全血T淋巴细胞亚群水平对高血压脑出血合并肺部感染的诊断价值。结果感染组年龄≥60岁、有慢性支气管炎、营养不良、使用抗菌药物例数高于未感染组(P<0.05)。感染组血清和肽素、PCT水平高于未感染组,全血CD3⁺、CD4⁺水平和CD4⁺/CD8⁺低于未感染组(P<0.05)。慢性支气管炎、高水平血清和肽素、PCT和低水平全血CD3⁺、CD4⁺/CD8⁺均为高血压脑出血合并肺部感染的独立危险因素(P<0.05)。血清PCT和CD4⁺/CD8⁺预测高血压脑出血合并肺部感染敏感性高于其他指标,血清和肽素预测高血压脑出血合并肺部感染特异性高于其他指标(P<0.05)。结论高血压脑出血合并肺部感染的危险因素主要包括慢性支气管炎、高水平血清和肽素、PCT和低水平全血CD3⁺、CD4⁺/CD8⁺,其中血清和肽素、PCT和CD4⁺/CD8⁺对高血压脑出血合并肺部感染有较高的诊断价值。

Risk factors for pulmonary infection in hypertensive cerebral hemorrhage patients and diagnostic value of copeptin

OBJECTIVE To analyze the risk factors for pulmonary infection in hypertensive cerebral hemorrhage patients and the diagnostic value of copeptin.METHODS A total of 150patients with hypertensive intracerebral hemorrhage who were treated in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from Jul 2017to May 2019were enrolled in the study and divided into the infection group with 64cases and the non-infection group with 85cases according to the status of complication with pulmonary infection.Multivariate logistic regression analysis was performed for risk factors for the pulmonary infection in the patients with hypertensive intracerebral hemorrhage,and the values of serum copeptin,PCT and whole blood T lymphocyte subsets in diagnosis of pulmonary infection were analyzed.RESULTS The number of cases with no less than 60years of age,chronic bronchitis,malnutrition and use of antibiotics was significantly larger in the infection group than in the non-infection group(P<0.05).The levels of serum copeptin and PCT of the infection group were significantly higher than those of the non-infection group,the whole blood CD3⁺,CD4⁺levels and CD4⁺/CD8⁺of the infection group were significantly lower than those of the non-infection group(P<0.05).Chronic bronchitis,high levels of serum copeptin and PCT and low levels of whole blood CD3⁺and CD4⁺/CD8⁺were independent risk factors for pulmonary infection in the patients with hypertensive intracerebral hemorrhage(P<0.05).The sensitivities of serum PCT and CD4⁺/CD8⁺were significantly higher than those of other indexes in prediction of pulmonary infection in the patients with hypertensive intracerebral hemorrhage,and the specificity of serum copeptin was significantly higher than that of other indexes in prediction of pulmonary infection(P<0.05).CONCLUSION The risk factors for pulmonary infection in the patients with hypertensive intracerebral hemorrhage include chronic bronchitis,high levels of serum copeptin and PCT and low levels of whole blood CD3⁺and CD4⁺/CD8⁺,and the serum copeptin,PCT and CD4⁺/CD8⁺have high value in diagnosis of the pulmonary infection in the patients with hypertensive intracerebral hemorrhage.