血浆BNP和PCT对老年重症肺部感染患者预后的预测价值比较

Comparison of Predicting Value of the prognostic of Plasma BNP and PCT in Elderly Patients with Severe Pulmonary Infection

目的:比较血浆脑钠肽(BNP)和降钙素原(PCT)对老年重症肺部感染患者预后的预测价值。方法:选取本院78例老年重症肺部感染患者为研究组,并选择同期78例老年一般肺部感染患者为对照组,对两组治疗前、治疗后1d、3d、7d血浆BNP和PCT水平进行测定,进而对血浆BNP和PCT在老年重症肺部感染患者预后的预测价值进行分析。结果:研究组患者治疗前血浆BNP水平明显较对照组高,其PCT水平亦明显较对照组高,差异均有统计学意义(均P<0.05)。研究组中病情改善者治疗后3d、7d血浆BNP和PCT水平明显较恶化者低,差异均有统计学意义(均P<0.05)。BNP评估患者预后的ROC曲线下面积为0.43,敏感度为0.72,特异度为0.56;PCT评估患者预后的ROC曲线下面积为0.92,敏感度为0.81,特异度为0.92。结论:相比血浆BNP,PCT对老年重症肺部感染患者预后的预测价值较高,其评估预后的灵敏度与特异度均高于BNP,故此可作为评估老年重症肺部感染患者预后情况的重要指标。92,敏感度为0.81,特异度为0.92。结论:相比血浆BNP,PCT对老年重症肺部感染患者预后的预测价值较高,其评估预后的灵敏度与特异度均高于BNP,故此可作为评估老年重症肺部感染患者预后情况的重要指标。

Objective： To compare the plasma brain natriuretic peptide（BNP） and procalcitonin（PCT） on the predictiveprognosis value of elderly patients with severe pulmonary infection. Methods： 78 cases of elderly patients with severe pulmonary infection as the study group were selected in our hospital,and 78 cases of elderly patients with general pulmonary infection were selected at the same period as the control group.Thelevels of plasma BNP and PCTbefore treatment,1 day,3 days and 7 days after treatment were measured of the two groups,and thepredictiveprognosis value of plasma BNP and PCT inelderly patients with severe pulmonary infection was analyzed. Results： Theplasma BNP level in the study group before treatment was significantly higher than in the control group and the PCT level was also significantly higher than in the control group,which showed that the differences were statistically significant（both P 0. 05）. Theplasma BNP and PCT levels 3 days and 7 days after treatment of those who improved in the study group were significantly lower than in the deterioration persons,which showed that the differences were statistically significant（all P 0.05）.The area under ROC curve in BNP for evaluation the prognosis of patients was 0.43,with sensitivity of 0.72 and the specificity of 0.56; the area under ROC curve in PCT for evaluation of the prognosis of patients was 0.92,with the sensitivity of 0.81 and the specificity of 0.92. Conclusion： Compared with plasma BNP,PCT in the predictiveprognosis value ofelderly patients with severe pulmonary infection is higher,which show thesensitivity and specificity for prognosis are high those in BNP,so it can be used as an important indicator to evaluate the prognosis of elderly patients with severe pulmonary infection.