重症肺部感染患者血清相关指标水平变化及意义

目的 探讨重症肺部感染患者血清C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)及脑钠肽(BNP)水平变化及意义。 方法 选择2015年12月—2019年8月杭州师范大学附属医院收治的入住ICU的467例重症肺部感染患者,根据患者年龄分为18~35岁组(172例)、36~60岁组(141例)和>60岁组(154例),根据存活情况分为存活组(349例)和死亡组(118例)。检测血清CRP、PCT、IL-6和BNP水平,Pearson分析年龄与CRP、PCT、IL-6及BNP之间关系;ROC分析CRP、PCT、IL-6及BNP水平对重症肺部感染的预后预测价值。 结果 血CRP、PCT、IL-6及BNP水平均与年龄具有显著相关性(均P<0.05);且不同年龄阶段存活组CRP、PCT、IL-6及BNP水平均明显低于死亡组(均P<0.05);血CRP、PCT、IL-6、BNP以及四者联合检测预测18~35岁组的AUC依次为0.759、0.729、0.690、0.798和0.889,预测36~60岁组的AUC依次为0.813、0.797、0.713、0.804和0.927,预测>60岁组的AUC依次为0.644、0.697、0.696、0.703和0.847。 结论 血清CRP、PCT、IL-6及BNP水平与年龄具有显著相关性,且联合检测对不同年龄阶段重症肺部感染患者的预后均具有较高的预测价值。 

Changes and significance of related serum indices levels in patients with severe pulmonary infection

Objective To explore changes and significance of levels of serum C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6) and brain natriuretic peptide(BNP) in patients with severe pulmonary infection. Methods A total of 467 patients with severe pulmonary infection who were admitted to Intensive Care Unit(ICU) of the Affiliated Hospital of Hangzhou Normal University from December 2015 to August 2019 were enrolled. According to age, patients were divided into 18-35 years group(172 cases), 36-60 years group(141 cases) and >60 years group(154 cases). According to survival within 30 d after admission in ICU, they were divided into survival group(349 cases) and death group(118 cases). Levels of serum CRP, PCT, IL-6 and BNP were measured. Pearson correlation analysis was applied to analyze correlation between age and CRP, PCT, IL-6, BNP. ROC curves were applied to analyze predictive value of CRP, PCT, IL-6 and BNP for prognosis of severe pulmonary infection patents at different age. Results The levels of serum CRP, PCT, IL-6 and BNP were significantly correlated with age(all P<0.05). The levels of CRP, PCT, IL-6 and BNP in the all survival group were significantly lower than those in the death group(all P<0.05). AUC of serum CRP, PCT, IL-6, BNP and their combination for predicting prognosis in 18-35 years group, 36-60 years group and >60 years group were(0.759, 0.729, 0.690, 0.798, 0.889),(0.813, 0.797, 0.713, 0.804, 0.927) and(0.644, 0.697, 0.696, 0.703, 0.847), respectively. Conclusion The levels of serum CRP, PCT, IL-6 and BNP are significantly correlated with age. The combined detection is of relatively higher predictive value for prognosis of patients with severe pulmonary infection at different age.