Ⅱ型肺泡细胞表面抗原与D-二聚体在医院获得性肺炎早期诊断及预后评估中的应用价值研究

Application value of KL-6 and D-dimer in early diagnosis and prognosis in patients with hospital-acquired pneumonia

目的探讨Ⅱ型肺泡细胞表面抗原(KL-6)与D-二聚体(DD)在医院获得性肺炎(HAP)早期诊断及预后评估中的应用价值。方法选取94例HAP患者作为HAP组,并选择50例健康者作为对照组,比较两组KL-6与DD水平。然后分别按照肺炎严重程度指数(PSI)、重症肺炎判断标准及预后将HAP患者进行分组,比较PSI不同严重程度、重症肺炎与非重症肺炎、生存组与死亡组之间KL-6与DD水平。结果与对照组相比,HAP组患者KL-6与DD水平显著升高,差异有统计学意义(P<0.05)。进行分组后,PSI危险程度越高,KL-6与DD水平越高(P<0.05),重症肺炎组与死亡组的KL-6与DD水平分别高于非重症肺炎组与生存组(P<0.05)。结论 HAP患者KL-6与DD水平显著高于健康者,且随着病情的加重呈现上升趋势,两者可以作为HAP的早期诊断及预后评估指标应用于临床。

【Objective】 To investigate the application value of Krebs Von den Lungen-6（KL-6） and Ddimer（DD） in early diagnosis and prognosis in patients with hospital-acquired pneumonia（HAP）. 【Methods】Totally 94 cases with HAP and 50 healthy subjects were selected to compare the levels of KL-6 and DD.Then, the cases with HAP were respectively grouped by pneumonia severity index（PSI）, judgement standard for severe pneumonia and prognosis. After that, the levels of KL-6 and DD were compared between different groups. 【Results】 The levels of KL-6 and DD were statistically higher in the cases with HAP than in the healthy subjects（both P 〈0.05）. After comparison between different groups, the more severe the HAP was, the statistically higher the levels of KL-6 and DD were（all P 〈0.05）. KL-6 and DD in the severe pneumonia cases were statistically higher than those in the non-severe pneumonia cases（both P 〈0.05）. And the survival group had statistically lower levels of KL-6 and DD than the death group（both P 〈0.05）. 【Conclusions】Levels of KL-6 and DD in HAP cases are significantly higher than those in healthy subjects, which present rising trends with the exacerbation of the disease. And KL-6 and DD could be used as the indices of early diagnosis and prognosis for HAP.