中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
3期
322-325
,共4页
蔡志明%林其昌%林晓%连宁芳
蔡誌明%林其昌%林曉%連寧芳
채지명%림기창%림효%련저방
降钙素%肺炎%社区获得性感染
降鈣素%肺炎%社區穫得性感染
강개소%폐염%사구획득성감염
Calcitonin%Pneumonia%Community-acquired infections
目的 评价降钙素原(PCT)对老年人社区获得性肺炎(CAP)严重程度的预测价值.方法 回顾性分析2010年1月至2011年9月入院的90例老年CAP住院患者PCT值与重症肺炎的关系. 结果 将患者依据诊断标准分为重症肺炎组36例,非重症肺炎组54例,两组间PCT值中位数分别为2.44 μg/L和0.11 μg/L,差异有统计学意义(U=335.50,P=0.000).以PCT＜0.5 μg/L为界值,非重症肺炎发生率为76％,而以PCT≥2μg/L为界值,非重症肺炎的发生率为9％.二分类logistic回归分析显示,PCT独立于年龄及CRUB-65评分为重症肺炎的危险因素(OR=1.328,95％CI:1.072～1.645).PCT值在不同CRUB-65评分患者间差异具有统计学意义,CRUB-65评分越高,PCT值也越高(U=10.162,P=0.006).在90例患者中,好转出院组与非好转出院组入院时PCT浓度中位数差异为0.21 μg/L与17.0 μg/L(U=10.000,P=0.000),而在重症CAP患者中,好转出院患者与非好转出院患者的入院PCT也有明显差异,中位数非别为1.47 μg/L与17.0 μg/L(U=8.000,P=0.000).根据PCT值绘制老年人重症CAP的受试者工作特征曲线(ROC),曲线下面积为0.827(95％CI:0.741～0.914).PCT取值为2.0μg/L时,诊断老年人重症CAP的敏感度为55.6％,特异度为98.9％. 结论 PCT可用于预测老年CAP的严重程度.
目的 評價降鈣素原(PCT)對老年人社區穫得性肺炎(CAP)嚴重程度的預測價值.方法 迴顧性分析2010年1月至2011年9月入院的90例老年CAP住院患者PCT值與重癥肺炎的關繫. 結果 將患者依據診斷標準分為重癥肺炎組36例,非重癥肺炎組54例,兩組間PCT值中位數分彆為2.44 μg/L和0.11 μg/L,差異有統計學意義(U=335.50,P=0.000).以PCT＜0.5 μg/L為界值,非重癥肺炎髮生率為76％,而以PCT≥2μg/L為界值,非重癥肺炎的髮生率為9％.二分類logistic迴歸分析顯示,PCT獨立于年齡及CRUB-65評分為重癥肺炎的危險因素(OR=1.328,95％CI:1.072～1.645).PCT值在不同CRUB-65評分患者間差異具有統計學意義,CRUB-65評分越高,PCT值也越高(U=10.162,P=0.006).在90例患者中,好轉齣院組與非好轉齣院組入院時PCT濃度中位數差異為0.21 μg/L與17.0 μg/L(U=10.000,P=0.000),而在重癥CAP患者中,好轉齣院患者與非好轉齣院患者的入院PCT也有明顯差異,中位數非彆為1.47 μg/L與17.0 μg/L(U=8.000,P=0.000).根據PCT值繪製老年人重癥CAP的受試者工作特徵麯線(ROC),麯線下麵積為0.827(95％CI:0.741～0.914).PCT取值為2.0μg/L時,診斷老年人重癥CAP的敏感度為55.6％,特異度為98.9％. 結論 PCT可用于預測老年CAP的嚴重程度.
목적 평개강개소원(PCT)대노년인사구획득성폐염(CAP)엄중정도적예측개치.방법 회고성분석2010년1월지2011년9월입원적90례노년CAP주원환자PCT치여중증폐염적관계. 결과 장환자의거진단표준분위중증폐염조36례,비중증폐염조54례,량조간PCT치중위수분별위2.44 μg/L화0.11 μg/L,차이유통계학의의(U=335.50,P=0.000).이PCT＜0.5 μg/L위계치,비중증폐염발생솔위76％,이이PCT≥2μg/L위계치,비중증폐염적발생솔위9％.이분류logistic회귀분석현시,PCT독립우년령급CRUB-65평분위중증폐염적위험인소(OR=1.328,95％CI:1.072～1.645).PCT치재불동CRUB-65평분환자간차이구유통계학의의,CRUB-65평분월고,PCT치야월고(U=10.162,P=0.006).재90례환자중,호전출원조여비호전출원조입원시PCT농도중위수차이위0.21 μg/L여17.0 μg/L(U=10.000,P=0.000),이재중증CAP환자중,호전출원환자여비호전출원환자적입원PCT야유명현차이,중위수비별위1.47 μg/L여17.0 μg/L(U=8.000,P=0.000).근거PCT치회제노년인중증CAP적수시자공작특정곡선(ROC),곡선하면적위0.827(95％CI:0.741～0.914).PCT취치위2.0μg/L시,진단노년인중증CAP적민감도위55.6％,특이도위98.9％. 결론 PCT가용우예측노년CAP적엄중정도.
Objective To analyze the plasma procalcitonin (PCT) as a predictor of the severity of community acquired pneumonia (CAP) in elderly patients.Methods Totally 90 elderly patients hospitalized with community acquired pneumonia from 2010 to 2011 were analyzed retrospectively for the relation between plasma procalcitonin and severity of pneumonia.All cases were divided into two groups,the severe group (n=36) and the non-severe group (n=54) according to diagnostic criteria.Results The level of plasma PCT was much lower in the severe group (median 2.44 μg/L) than that in the non-severe group (median 0.11 μg/L) (U=335.50,P=0.000).Among all patients,when PCT was lower than 0.5 μg/L,the incidence of non-severe CAP was 76％,however,when PCT was equal or above 2.0 μg/L,the incidence of non-severe CAP was reduced to 9％.In Binary logistic regression analysis,PCT was a risk factor of aged person with severe community acquired pneumonia independent of age and CRUB-65 scores [OR =1.328 (95 ％ confidential interval:1.072,1.645)].PCT had a positive correlation with CRUB-65 scores (U=10.162,P=0.006).In all cases,the patients who improved well had lower PCT value than the remaining (median 0.21 μg/L,17.0μg/L; U=10.000,P=0.000),which also happened in severe cases (median 1.47 μg/L,17.0 μg/L;U=8.000,P=0.000).The area under the receiver operating characteristic curve was 0.872 (95％ confidential interval:0.741,0.914).At a PCT cut-off level of greater than or equal to 2.0 μg/L,the sensitivity and specificity to predict the severity of aged person with CAP was 55.6％ and 98.9％ respectively.Conclusions Plasma PCT may be a good predictor to evaluate the severity of CAP in elderly patients.
