瘦素、C-反应蛋白与CPIS在评价CAP预后中的价值

目的探讨血浆瘦素(LEP)、C-反应蛋白(CRP)水平及临床肺部感染评分(CPIS)在评价社区获得性肺炎(CAP)预后中的价值。方法收集98例CAP患者的临床资料,检测患者入院第1天、第7天的LEP、CRP并进行CPlS评分。根据预后分为生存组和死亡组,并设立对照组,分析各观察指标在各组间及治疗前后的差异,并通过ROC曲线,评估LEP、CPlS对CAP死亡率的预测。结果人院1 d LEP、CRP和CPIS在生存组与死亡组之间差异无统计学意义。治疗7 d后与1 d相比,生存组LEP和CPIS明显下降(P<0.01),死亡组差异无统计学意义(P>0.05);死亡组LEP、CRP和CPIS明显高于生存组(P<0.01)。根据ROC曲线:联合应用LEP、CPIS预测CAP死亡率时,敏感性和特异性较单独应用时均明显升高。结论动态监测LEP、CRP和CPIS对于评价CAP预后具有重要的临床指导意义。

The value of leptin, C-reactive protein and CPIS in the evaluation of community acquired pneumonia prognosis

Objective To investigate the plasma leptin(LEP),C-reactive protein(CRP) level and clinical pulmonary infection score(CPIS) in the evaluation of community acquired pneumonia(CAP) prognostic value.Methods 98 CAP patients′ LEP and CRP were detected and they were given CPIS at the first and seventh days in hospital.All the patients were divided into the survival group,the death group and the control group based on prognosis,and then all the related data were detected and analyzed among the three groups.LEP and CPIS′ changes were evaluated by mortality using the ROC curve.Results There was no significant difference between the survival group and the death group at Day 1.Through 7 days treatment,LEP and CPIS of the survival group decreased obviously with statistical significance(P< 0.01),whereas no statistical significance in the death group(P>0.05).Besides,LEP,CRP and CPIS of the death group were significantly higher than the survival group(P<0.01).According to the ROC curve,the sensitivity and the specificity of the CAP patients′ mortality increased obviously while combining the applications of LEP and CRP.Conclusion Dynamic monitoring of LEP,CRP and CPIS for the evaluation of the prognosis of CAP has an important clinical significance.