重症肺炎患者MSCT影像学征象、CPIS评分、PCT水平与病情严重程度的关系研究

Study on the Relationship between MSCT Imaging Signs,CPIS Score,PCT Level and Disease Severity in Patients with Severe Pneumonia

目的:探讨重症肺炎患者多层螺旋电子计算机断层扫描(MSCT)影像学征象、临床肺部感染评分(CPIS)、降钙素原(PCT)水平与病情严重程度的关系,从而为临床治疗提供参考依据。方法:选取我院2022年1月至2023年2月收治的100例重症肺炎患者作为观察组,并根据其入院时急性生理与慢性健康(APACHEⅡ)将其分为非危重症组(28例)、危重症组(42例)以及急危重症组(30例),另选取同期于我院进行治疗的普通肺炎患者110例作为对照组。比较对照组与观察组MSCT影像学征象、CPIS评分、PCT水平,不同组别重症肺炎MSCT影像学征象、CPIS评分、PCT水平,分析MSCT影像学征象、CPIS评分、PCT水平与病情严重程度的相关性,并对典型病例进行分析。结果:与对照组相比,观察组MSCT出现磨玻璃样改变、斑片影改变以及肺实变等影像学征象患者占比均更高;CPIS得分以及血清PCT水平高于对照组,差异具有统计学意义(P<0.05);不同严重级别的重症肺炎患者MSCT出现磨玻璃样改变影像学征象患者占比呈逐渐降低趋势;CPIS得分以及血清PCT水平呈逐渐升高趋势,差异具有统计学意义(P<0.05);3组MSCT出现斑片影改变、肺实变等影像学征象患者占比相比差异无统计学意义(P>0.05);经Pearson相关系数分析,MSCT中磨玻璃样改变影像学征象与重症肺炎患者的病情严重程度呈负相关关系,CPIS评分以及血清PCT水平与重症肺炎患者的病情严重程度呈正相关关系(r=-0.67,0.99,0.45,P<0.05)。结论:重症肺炎患者MSCT影像学征象中磨玻璃样改变减少,而CPIS得分以及血清PCT水平越高,则重症肺炎患者的病情越危急,临床医师可以此为指导对患者病情进行相应评估,从而判断重症肺炎患者危急程度,从而制定针对性治疗方案。

Objective:To investigate the relationship between the imaging signs of multi-slice spiral computed tomography(MSCT),clinical pulmonary infection score(CPIS),procalcitonin(PCT)levels and the disease severity in patients with severe pneumonia,in order to provide a reference for clinical treat⁃ment.Methods:100 patients with severe pneumonia admitted to our hospital from January 2022 to Febru⁃ary 2023 were selected as the observation group,and were divided into non-critical group(28 cases),critical group(42 cases)and acute critical group(30 cases)according to their acute physiological and chronic health(APACHEⅡ)at admission.Another 110 patients with common pneumonia treated in our hospital during the same period were selected as the control group.The MSCT imaging signs,CPIS score and PCT level between the control group and observation group,and those among different severe pneu⁃monia group were compared,and the correlation between the MSCT imaging signs,CPIS score and PCT level and the severity of the disease were analyzed,and typical cases were analyzed.Results:Compared with the control group,the observation group had a higher proportion of MSCT imaging signs such as ground glass change,spot shadow change and lung consolidation,CPIS score and serum PCT level were higher than the control group,and the differences were statistically significant(P<0.05).The proportion of patients with MSCT with ground-glass changes showed a gradually decreasing trend in patients with se⁃vere pneumonia of different severity levels.CPIS score and serum PCT level showed a gradually increas⁃ing trend,and the differences were statistically significant(P<0.05).There was no significant difference in the proportion of patients with MSCT imaging signs such as spot shadow change and lung consolidation among all groups(P>0.05).According to Pearson correlation coefficient analysis,ground-glass imaging signs in MSCT were negatively correlated with the severity of severe pneumonia,while CPIS score and se⁃rum PCT level were positively correlated with the severity of severe pneumonia(r=-0.67,0.99,0.45,P<0.05).Conclusion:The MSCT imaging signs of patients with severe pneumonia showed less ground-glass changes,and the higher the CPIS score and serum PCT level,the more critical the condition of patients with severe pneumonia.Clinicians can use this as a guide to make corresponding assessment of patients'conditions,so as to judge the critical degree of patients with severe pneumonia,so as to develop targeted treatment plans.