血清降钙素原联合DIC评分系统在重症肺炎急性肾损伤中的价值

Clinical value of serum calcitonin and DIC scoring system in diagnosis of acute renal injury in severe pneumonia patients

目的探讨血清降钙素原(PCT)联合DIC评分系统(ISTH)在诊断重症肺炎患者急性肾损伤(AKI)中的临床价值。方法收集2015年10月—2017年2月收治的102例重症肺炎患者的临床资料以及随访资料进行回顾性分析,根据出院诊断分为AKI组(47例)和非AKI组(55例),入院24 h内检测两组患者血清降钙素原水平,并比较组间差异。绘制ROC曲线,观察ISTH评分联合PCT、ISTH评分、PCT、慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分(SOFA)评分在诊断重症肺炎患者AKI中的临床价值。结果 AKI组患者ISTH评分、APAHEⅡ评分、PCT水平均明显高于非AKI组患者,SOFA评分明显低于非AKI组患者,组间比较差异存在统计学意义(P<0.05);根据ROC曲线结果显示:ISTH评分、APAHEⅡ评分、SOFA评分、PCT在ROC曲线下的面积均>0.8;ISTH评分和PCT2个指标联合对重症肺炎患者AKI的敏感度为78.11%,特异度为100.00%。结论血清降钙素原可作为重症肺炎患者急性肾损伤的特异性指标,且联合DIC评分系统诊断重症肺炎患者急性肾损伤具有更高的临床价值。

Objective To explore the clinical value of serum calcitonin（ PCT） combined with DIC scoring system（ ISTH） in the diagnosis of acute renal injury（ AKI） in severe pneumonia. Methods Collected from October 2015 to February 2017 in our hospital 102 cases of patients with severe pneumonia general information,clinical and follow-up data were retrospectively analyzed,according to the hospital diagnosis is divided into AKI（ 47 cases） and non AKI group（ 55 cases）,admitted to hospital within 24 h two groups of patients with serum calcitonin level,and compare the differences between groups. ROC curve drawing,observing ISTH grade combined PCT,ISTH,PCT,APACHE Ⅱscore,SOFA score clinical value in diagnosis of patients with severe pneumonia AKI. Results The patients with AKI group ISTH score,APAHE Ⅱ score,PCT levels were significantly higher than those of the non AKI group,SOFA score was lower than that in non AKI group,more obvious differences between groups（ P〈 0. 05）; According to the ROC curve results showed that ISTH score,APAHE Ⅱ score,SOFA score,PCT in the area under the ROC curve 0. 8;The sensitivity of ISTH score and PCT2 combined to AKI in severe pneumonia was 78. 11% and the specificity was100. 00%. Conclusion Serum calcitonin original can be as an indicator of acute kidney injury in patients with severe pneumonia specificity,and in combination with DIC scoring system in the diagnosis of acute kidney injury in patients with severe pneumonia has higher clinical value.