| 摘要: |
| ［摘要］ 目的 探讨CURB-age评分联合炎症因子检测预测老年社区获得性肺炎（CAP）患者短期预后的价值。方法 收集2016-01～2020-02郑州大学第二附属医院呼吸内科普通病房及重症监护病房（ICU）收治的112例老年CAP患者的临床资料，根据患者的30 d临床结局将其分为存活组（95例）和死亡组（17例）。比较两组的临床资料，采用多因素logistic回归分析探讨影响老年CAP患者发生死亡事件的危险因素。通过绘制ROC曲线分析不同联合模型对老年CAP患者30 d发生死亡事件的预测价值。结果 存活组CURB-age评分、CURB-65评分以及C反应蛋白（CRP）、CRP/前白蛋白（PA）、降钙素原（PCT)和白细胞（WBC)水平低于死亡组，而PA水平高于死亡组，差异有统计学意义（P<0.05）。logistic回归分析结果显示，较高的CURB-age评分是促进老年CAP患者发生死亡的危险因素（OR=5.529，P=0.015）。CURB-age评分、CURB-age评分+CRP模型、CURB-age评分+PA模型、CURB-age评分+CRP/PA模型、CURB-age评分+PCT模型、CURB-age评分+WBC模型的ROC曲线下面积（AUC）分别为0.894、0.929、0.947、0.949、0.916、0.906，提示均具有较好的预测效能（P<0.05）。且进一步分析显示，CURB-age评分+PA模型、CURB-age评分+CRP/PA模型的AUC均显著大于CURB-age评分的AUC（Z=2.326,P=0.020;Z=2.496,P=0.013）,但其他各模型之间的AUC比较差异无统计学意义（P>0.05）。结论 CURB-age评分对老年CAP患者的短期预后具有良好的临床预测价值，且优于CURB-65评分，联合PA可显著提高其预测效能。 |
| 关键词: 社区获得性肺炎 老年人 CURB-age评分 炎症因子 预后 |
| DOI：10.3969/j.issn.1674-3806.2021.04.13 |
| 分类号:R 563.1 |
| 基金项目:河南省基础与前沿技术研究计划项目（编号：152300410051） |
|
| The value of CURB-age score combined with inflammatory factor detection in predicting the short-term prognosis of elderly patients with community-acquired pneumonia |
|
WANG Qing-xiu, LIU Jian-bo, SHAO Run-xia, et al.
|
|
Department of Respiratory Medicine, the Second Affiliated Hospital of Zhengzhou University, Henan 450014, China
|
| Abstract: |
| ［Abstract］ Objective To explore the value of CURB-age score combined with inflammatory factor detection in predicting the short-term prognosis of elderly patients with community-acquired pneumonia(CAP). Methods The clinical data of 112 elderly patients with CAP admitted to the General Ward and the Intensive Care Unit(ICU) of the Department of Respiratory Medicine, the Second Affiliated Hospital of Zhengzhou University, were collected from January 2016 to February 2020, and the patients were divided into survival group(95 cases) and death group(17 cases) according to their 30-day clinical outcomes. The clinical data were compared between the two groups, and multivariate logistic regression analysis was used to explore the risk factors affecting the death of the elderly CAP patients. The receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of different combined models for 30-day mortality in the elderly CAP patients. Results The CURB-age scores, CURB-65 scores, and the levels of C-reactive protein(CRP), CRP/prealbumin(PA), procalcitonin(PCT) and white blood cell(WBC) in the survival group were lower than those in the death group, while the level of PA in the survival group was higher than that in the death group, and the differences were statistically significant(P<0.05). The results of logistic regression analysis showed that a higher CURB-age score was a risk factor of death for the elderly CAP patients(OR=5.529, P=0.015). The areas under ROC curve(AUC) of CURB-age score, CURB-age score+CRP model, CURB-age score+PA model, CURB-age score+CRP/PA model, CURB-age score+PCT model and CURB-age score+WBC model were 0.894, 0.929, 0.947, 0.949, 0.916 and 0.906, respectively, suggesting that all of them had good predictive power(P<0.05). Further analysis showed that the AUCs of CURB-age score+PA model and CURB-age score+CRP/PA model were significantly greater than the AUC of CURB-age score(Z=2.326, P=0.020; Z=2.496, P=0.013), however there was no statistically significant difference in AUC among the other models(P>0.05). Conclusion CURB-age score has good clinical predictive value for the short-term prognosis of elderly CAP patients, and is better than CURB-65 score. CURB-age score combined with PA can significantly improve its predictive efficacy. |
| Key words: Community-acquired pneumonia(CAP) The elderly CURB-age score Inflammatory factors Prognosis |
