胱抑素C预测重症肺炎的价值分析

Clinical value of cystatin C in predicting severe pneumonia

目的分析胱抑素C水平预测重症肺炎的临床价值.方法回顾性分析中国医科大学附属盛京医院呼吸科2016年1月至2018年6月住院治疗的社区获得性肺炎(CAP)患者213例的临床资料,根据病情分为重症肺炎组95例、非重症肺炎组118例,分析两组患者入院时血肌酐、血尿素氮、血清胱抑素C、C反应蛋白(CRP)浓度及意识改变、血尿素氮、呼吸频率、血压、年龄> 65岁(CURB-65)评分,比较重症肺炎与非重症肺炎患者的临床危险因素.结果重症肺炎组血清胱抑素C、血尿素氮、CRP分别为(1.32±0.47) mg/L、(7.73±5.79) mmol/L、(127.25±81.49) mg/L,非重症肺炎组分别为(1.06±0.33) mg/L、(5.06±2.41) mmol/L、(45.50±44.28) mg/L,两组差异均有统计学意义(t=4.469、4.218、8.789,均P<0.05);两组CURB-65评分差异有统计学意义(Z=-6.892,P<0.05);logistic回归统计分析显示,血清胱抑素C和CRP是重症肺炎的独立危险因素.结论重症肺炎患者血清胱抑素C水平较非重症肺炎患者高,提示胱抑素C对于预测重症肺炎有一定的价值,对于该指标应给予足够重视.

Objective To analyze the expression and clinical significance of cystatin C in patients with severe pneumonia.Methods The retrospective study method was used to collect 213 CAP patients who were hospitalized in Department of Respiration,Shengjing Hospital Affiliated to China Medical University from January 2016 to June 2018,in accordance with the inclusion and exclusion criteria,95 cases in severe pneumonia group,and 118 cases of non severe pneumonia group.The clinical data of blood creatinine,blood urea nitrogen,cystatin C,C reactive protein (CRP) concentration and CURB-65 (confusion,urea,respiratory rate,blood pressure,age > 65 years) score were analyzed in the two groups,and the clinical risk factors of severe pneumonia and non severe pneumonia were compared.Results In the severe pneumonia group,the values of cystatin C,blood urea nitrogen and CRP were (1.32 ±0.47) mg/L,(7.73 ± 5.79) mmol/L and (127.25 ± 81.49) mg/L,respectively,which in the non severe pneumonia group were (1.06 ± 0.33) mg/L,(5.06 ± 2.41) mmol/L and (45.50 ± 44.28) mg/L,respectively,the differences between the two groups were statistically significant (t =4.469,4.218,8.789,all P <0.05).The CURB-65 scores between the two groups had statistically significant difference (Z =-6.892,P < 0.05).Logistic regression analysis showed that cystatin C and CRP were independent risk factors for severe pneumonia.Conclusion The cystatin C level in patients with severe pneumonia is higher than that of patients with non severe pneumonia patients,suggesting that cystatin C has clinical value in predicting severe pneumonia and should be paid enough attention.