成都医学院学报
成都醫學院學報
성도의학원학보
Journal of Chengdu Medical College
2015年
5期
578-581
,共4页
降钙素原%老年%重症肺炎%降阶梯治疗%应用价值
降鈣素原%老年%重癥肺炎%降階梯治療%應用價值
강개소원%노년%중증폐염%강계제치료%응용개치
Procalcitonin%Elderly%Severe Pneumonia%De-escalation Treatment%Application Value
目的：评价血清降钙素原(procalcitionin,PCT)在老年重症肺炎患者降阶梯治疗转换节点中的应用价值。方法选择2012年6月至2014年12月南京市中心医院急诊科及内科重症监护病房收治的老年重症肺炎患者共80例,入院后每天采静脉血测定 PCT 水平,根据肺部感染全身性炎症反应综合征(SIRS)及局部反应监测转换节点的 PCT 水平,观察抗生素使用时间、机械通气时间、二重感染发生率、住院时间、住院费用及疗效等指标。结果治愈者与未治愈者转换节点上的血清 PCT 浓度分别为(1.82±1.21)ng/mL 和(4.70±3.25)ng/mL,两组比较,差异有统计学意义(t =-6.67,P <0.001)。转换节点上的 PCT 工作特征曲线(receiver operating characteristic curve,ROC 曲线)下面积为0.80,最佳临界值为2.39 ng/mL,灵敏度为80.00%,特异度为85.70%。结果表明,转换节点上的 PCT 值可较好地预测老年重症肺炎临床预后。PCT≥2.39 ng/mL 组二重感染发生率、抗生素使用时间、机械通气时间、住院时间及住院费用均明显高于 PCT<2.39 ng/mL 组(P <0.05)。结论以 PCT数值2.39 ng/mL为界点,在指导老年重症肺炎患者的降阶梯治疗转换节点中有一定的临床价值。
目的：評價血清降鈣素原(procalcitionin,PCT)在老年重癥肺炎患者降階梯治療轉換節點中的應用價值。方法選擇2012年6月至2014年12月南京市中心醫院急診科及內科重癥鑑護病房收治的老年重癥肺炎患者共80例,入院後每天採靜脈血測定 PCT 水平,根據肺部感染全身性炎癥反應綜閤徵(SIRS)及跼部反應鑑測轉換節點的 PCT 水平,觀察抗生素使用時間、機械通氣時間、二重感染髮生率、住院時間、住院費用及療效等指標。結果治愈者與未治愈者轉換節點上的血清 PCT 濃度分彆為(1.82±1.21)ng/mL 和(4.70±3.25)ng/mL,兩組比較,差異有統計學意義(t =-6.67,P <0.001)。轉換節點上的 PCT 工作特徵麯線(receiver operating characteristic curve,ROC 麯線)下麵積為0.80,最佳臨界值為2.39 ng/mL,靈敏度為80.00%,特異度為85.70%。結果錶明,轉換節點上的 PCT 值可較好地預測老年重癥肺炎臨床預後。PCT≥2.39 ng/mL 組二重感染髮生率、抗生素使用時間、機械通氣時間、住院時間及住院費用均明顯高于 PCT<2.39 ng/mL 組(P <0.05)。結論以 PCT數值2.39 ng/mL為界點,在指導老年重癥肺炎患者的降階梯治療轉換節點中有一定的臨床價值。
목적：평개혈청강개소원(procalcitionin,PCT)재노년중증폐염환자강계제치료전환절점중적응용개치。방법선택2012년6월지2014년12월남경시중심의원급진과급내과중증감호병방수치적노년중증폐염환자공80례,입원후매천채정맥혈측정 PCT 수평,근거폐부감염전신성염증반응종합정(SIRS)급국부반응감측전환절점적 PCT 수평,관찰항생소사용시간、궤계통기시간、이중감염발생솔、주원시간、주원비용급료효등지표。결과치유자여미치유자전환절점상적혈청 PCT 농도분별위(1.82±1.21)ng/mL 화(4.70±3.25)ng/mL,량조비교,차이유통계학의의(t =-6.67,P <0.001)。전환절점상적 PCT 공작특정곡선(receiver operating characteristic curve,ROC 곡선)하면적위0.80,최가림계치위2.39 ng/mL,령민도위80.00%,특이도위85.70%。결과표명,전환절점상적 PCT 치가교호지예측노년중증폐염림상예후。PCT≥2.39 ng/mL 조이중감염발생솔、항생소사용시간、궤계통기시간、주원시간급주원비용균명현고우 PCT<2.39 ng/mL 조(P <0.05)。결론이 PCT수치2.39 ng/mL위계점,재지도노년중증폐염환자적강계제치료전환절점중유일정적림상개치。
Objective To Evaluate the application value of procalcitionin(PCT)in the switching node of order de-escalation treatment for elderly patients with severe pneumonia. Methods A total of 80 cases of severe pneumonia patients in our emergency treatment & medical intensive care unit admitted from June 2012 to December 2014 were selected and their PCT levels were measured based on their venous blood.Indicators including the average service time of antibiotics,mechanical ventilation time,double infection,length of stay,hospitalization expenses and curative effect were observed according to SIRS and PCT numerical value of local reaction monitoring transition point.Results The mean of PCT in transition point for healed patients was significantly higher than the unhealed group (t=-6.67,P <0.001).The ROC curve was 0.80 and cut off value was 2.39 ng/mL.The values of average service time,mechanical ventilation time,double infection,hospital days,hospitalization expenses were higher in the group with a PCT level of at least 2.39 ng/mL than in the group with less than 2.39 ng/mL (P < 0.05 ). Conclusion Taking PCT numerical value 2.39 ng/mL as a threshold point,it has some clinical value in the switching node of order de-escalation treatment for elderly patients with severe pneumonia.
