论文部分内容阅读
目的:探讨降钙素原和简化临床肺部感染评分对呼吸机相关性肺炎诊断及预后评估的价值。方法:研究对象选自湖南省第二人民医院ICU接受机械通气≥48h的患者,其中VAP患者23例,非VAP患者43例,诊断当天两组CRP、PCT和CPIS差异,诊断后第28天比较VAP患者存活组和死亡组上述指标的差异,并进行ROC分析。结果:VAP患者CRP、PCT和CPIS高于非VAP患者,CRP诊断准确度较低(AUC=0.68),PCT和CPIS具有中等准确度(AUC=0.81,AUC=0.75),联合应用CPIS和PCT,诊断特异度提高至79.1%。VAP患者死亡组PCT和CPIS明显高于VAP存活组,联合应用CPIS和PCT,特异度提高至78.6%。结论:CPIS和PCT有助于VAP的诊断和预后评估,二者联合应用明显提高特异度,更具实用价值。
Objective: To investigate the value of procalcitonin and simplified clinical lung infection score in diagnosis and prognosis of ventilator-associated pneumonia. Methods: The subjects were selected from ICU of Hunan Second People’s Hospital for mechanical ventilation ≥48h, including 23 cases of VAP and 43 cases of non-VAP. The difference of CRP, PCT and CPIS between the two groups on the day of diagnosis was compared on the 28th day after diagnosis VAP patients survival group and death group the above indicators differences, and ROC analysis. Results: The CRP, PCT and CPIS were higher in patients with VAP than those without VAP. The accuracy of CRP was lower (AUC = 0.68), PCT and CPIS were moderate (AUC = 0.81, AUC = 0.75) The diagnostic specificity increased to 79.1%. PCT and CPIS in the death group were significantly higher than those in the VAP group. The combined use of CPIS and PCT increased the specificity to 78.6%. Conclusion: CPIS and PCT contribute to the diagnosis and prognosis evaluation of VAP. The combination of the two can significantly improve the specificity and have more practical value.