重症肺炎患者预后和APACHE_Ⅱ评分及降钙素原水平变化的监测分析

Surveillance and analysis of prognosis,APACHEⅡscore and procalcitonin level in patients with severe pneumonia

目的监测分析重症肺炎患者预后和急性生理与慢性健康评分(APACHEⅡ)、降钙素原(PCT)水平变化之间的联系。方法对比分析2015年6月至2017年6月在呼吸内科收治的123例重症肺炎患者的临床资料。比较生存组和死亡组APACHEⅡ评分和PCT水平的差异。结果入院后24h,存活组的APACHEⅡ评分和PCT分别为(20.23±3.76)μg/L和(10.32±3.14)μg/L,死亡组为(24.47±4.15)μg/L和(12.24±2.84)μg/L,APACHEⅡ评分差异有统计学意义(P<0.05),PCT差异无统计学意义(P>0.05)。存活组中的APACHEⅡ和PCT水平从入院后72h逐渐减少至治疗结束,而死亡组逐渐增加。两组间APACHEⅡ和PCT差异均有统计学意义(P<0.05)。结论PCT指数不足以评估24h内重症肺炎患者的预后。APACHEⅡ和PCT的动态监测可以及时掌握患者病情的严重程度,值得临床加以重视。

Objective To Monitor and analysis of the relationship between prognosis and changes inprocalcitoninAcute Physiology and Chronic Health Evaluation(APACHEⅡ)and procalcitonin(PCT)levels in patients with severe pneumonia.Methods The clinical data of 123 patients with severe pneumonia admitted to the Department of Respiratory Medicine from June 2015 to June 2017 were compared.The differences in APACHE H scores and PCT levels between the survival and death groups were compared.Results At 24 hours after admission,the APACHEⅡscore and PCT for the surviving group were(20.23±3.76)μg/L and(10.32士3.14)yg/L,respectively,and the death group was(24.47±4.15)fig/L and(12.24±2.84)ptg/L.There showed significant difference in APACHEⅡscores(P<0.05),and there was no significant difference in PCT(P〉0.05).APACHEⅡand PCT levels in the survival group gradually decreased from 72 hours after admission to the end of treatment,while the death group gradually increased.There showed significant difference between APACHEⅡand PCT between the two groups(P<0.05).Conclusions The PCT index is not sufficient to assess the prognosis of patients with severe pneumonia within 24 hours.The dynamic monitoring of APACHEⅡand PCT can timely grasp the severity of the patient's condition and deserves clinical attention.