血清PCT及CPIS评分对慢性阻塞性肺疾病患者呼吸机相关性肺炎的诊断及预后评估

Diagnostic value and prognosis evaluation of serum PCT and CPIS score for COPD patients with ventilator associated pneumonia

目的探讨血清降钙素原(PCT)及临床肺部感染评分(CPIS评分)对慢性阻塞性肺疾病患者呼吸机相关性肺炎的诊断及治疗价值。方法选取2014年2月-2016年4月我院收治的慢性阻塞性肺疾病患者83例,根据呼吸机相关性肺炎诊断结果分为确诊组和未确诊组,根据临床结果分为死亡组和存活组,比较患者的PCT水平和CPIS评分,并进行受试者工作特征曲线(ROC曲线)分析。结果确诊组、死亡组患者的PCT、CPIS评分均明显高于未确诊组、存活组(P<0.05)。PCT、CPIS评分、PCT+CPIS评分的诊断AUC分别为0.817、0.856、0.932,预测AUC分别为0.789、0.723、0.805。结论血清PCT及CPIS评分对慢性阻塞性肺疾病患者呼吸机相关性肺炎的诊断和治疗结局的预测具有重要意义,两者结合可作为临床评估的辅助手段。

Objective To investigate the diagnostic value and prognosis evaluation of serum PCT and CPIS score for COPD patients with ventilator associated pneumonia. Methods 83 COPD patients were selected from Feb- ruary 2014 to April 2016 in our hospital, and then they were divided into the confirmed-diagnosis group and uncon- firmed diagnosis group according to the diagnosis of ventilator-associated pneumonia, and the death group and the sur- vival group according to the clinical results. Their PCT level and CPIS score were compared and analyzed by receiver operating characteristic curve （ROC curve）. Results Their PCT level and CPIS score were significantly higher in the confirmed diagnosis group and the death group than in the unconfirmed diagnosis group and the survival group （P 〈0.05）. The area under ROC curve of PCT, CPIS, and PCT ＋ CPIS was 0. 817, 0. 856 and 0. 932, respectively, and the prediction of AUC was 0. 789,0.723, and 0.805. Conclusion Serum PCT revel and CPIS score have im- portant significance in the diagnosis and prognosis evaluation of COPD patients with ventilator associated pneumonia.