降钙素原与临床肺部感染评分在呼吸机相关性肺炎预后评估中的价值

Value of procalcitonin and clinical pulmonary infection score on prognosis of ventilator-associated pneumonia

目的探讨降钙素原(PCT)与临床肺部感染(CPIS)评分在呼吸机相关性肺炎(VAP)预后评估中的价值。方法 65例VAP患者根据临床转归分为生存组和死亡组,动态监测两组患者入院第1天、第5天及转出或死亡前PCT、CPIS评分及APACHEⅡ评分的动态变化,并分析三者之间的相关性。结果两组患者在年龄、入住ICU时间、机械通气时间、CPIS评分及APACHEⅡ评分等方面比较无显著差异性(P>0.05);生存组第5天和转出或死亡前PCT、CPIS评分及APACHEⅡ评分等指标明显低于死亡组(P<0.05);PCT与CPIS评分呈正相关(r=0.647,P<0.01),PCT、CPIS评分均与APACHEⅡ评分呈正相关(r=0.735,P<0.01和r=0.548,P<0.01)。结论动态监测PCT与CPIS评分对VAP患者预后评估具有较好的临床价值。

Objective To investigate the value of procalcitonin （ PCT ） and clinical pulmonary infection （ CPIS） score on prognosis of ventilator-associated pneumonia （ VAP） . Methods 65 VAP patients were divided into the survival group and the death group according to their clinical outcomes, and the changes of PCT, CPIS score and APACHEⅡ in the two groups were dynamically monitored respectively at the first and fifth days upon admission. The correlation among them was also analyzed. Results There was no significant difference between the two groups in age, ICU stay, mechanical ventilation time, CPIS score and APACHEⅡscore （P〉0. 05）. The value of PCT, CPIS score and APACHEⅡscore at the fifth day was significantly lower in the survival group than in the death group （ P〈0. 05）. PCT score was positively correlated with CPIS （r=0. 647, P〈0. 01）. PCT and CPIS scores were positively correlated with APACHEⅡ （r=0. 735, P 〈0. 01 and r =0. 548, P 〈0. 01）. Conclusion Dynamic monitoring PCT and CPIS has a good prognostic clinical value for VAP patients.