降钙素原对慢性阻塞性肺疾病急性加重患者应用机械通气治疗的预测价值

Predictive value of procalcitation on acute exacerbation chronic obstructive pulmonary diseases patients with mechanical ventilation

目的：探讨降钙素原（PCT）对慢性阻塞性肺疾病急性加重（AECOPD）患者应用机械通气治疗的预测价值。方法选取2014年2月~2015年5月入院的126例AECOPD患者,根据患者后续治疗方式将其分为单纯用药组（n=58）和机械通气组（n=68）,机械通气组进一步分为无创机械通气组（NIMV组,n=38）及有创机械通气组（IMV组,n=30）。构建ROC曲线,分析降钙素原对AECOPD患者行机械通气的预测价值。结果IMV组的PCT值明显高于NIMV组,且两组均高于单纯用药组,差异有统计学意义（P〈0.05或P〈0.01）。经ROC曲线分析,PCT预测AECOPD患者应用机械通气治疗的曲线下面积为0.69（P〈0.05）,区分NIMV及IMV的最佳截断值为0.89 ng/ml。结论 PCT可对AECOPD患者应用机械通气治疗进行预测,并可预测机械通气治疗方式的类型。

Objective To evaluate the predictive value of procalcitonin （PCT）on acute exacerbation chronic obstructive pulmonary diseases （AECOPD） patients with mechanical ventilation. Methods 126 hospitalized patients with AECOPD from February 2014 to May 2015 were selected,and they were divided into simple drug treatment group （n=58）and mechanical ventilation group （n=68） according to the follow-up treatment.Mechanical ventilation group was further divided into noninvasive mechanical ventilation group （NIMV group,n=38） and invasive mechanical ventilation group （IMV group,n=30）.The predictive value of PCT on AECOPD patients with mechanical ventilation was evaluated through ROC curve. Results PCT level in AECOPD patients with NIMV group was higher than that in IMV group,and both were higher than that in simple drug treatment group.The difference was statistically significant （P〈0.05 or P〈0.01）. Through ROC curve analysis,the area under curve for PCT predicting AECOPD patients with mechanical ventilation was 0.69（P〈0.05）.The optimal cutoff value of PCT level for distinguishing NIMV from IMV was 0.89 ng/ml. Conclusion Procalcitonin can be used for predicting mechanical ventilation in patients with AECOPD,and the type of mechanical ventilation as well.