HMGB-1联合PCT在早产儿VAP诊断中的临床意义

Clinical Significance of HMGB-1 Combined with PCT in the Diagnosis of Premature Infants with VAP

目的:分析HMGB-1联合PCT在VAP诊断中的临床意义.方法:采集2017年1月-2019年6月笔者所在医院新生儿重症监护室收治的80例早产儿作为观察对象,其中分为早产儿VAP组(40例)和早产儿非VAP组(40例).比较两组机械通气前、机械通气48 h、机械通气96 h、撤机前支气管分泌物HMGB-1与血液HMGB-1水平的比值及PCT浓度.结果:(1)早产儿VAP组在机械通气后48、96 h支气管分泌物HMGB-1与血液HMGB-1水平比值高于早产儿非VAP组,差异均有统计学意义(P<0.05).(2)机械通气后48 h早产儿VAP组血PCT浓度高于早产儿非VAP组,差异有统计学意义(P<0.05).(3)HMGB-1联合PCT诊断的准确度为88.75%,灵敏度为85.00%,特异度为92.50%.结论:HMGB-1联合PCT在早产儿VAP诊断中具有重要临床意义,提高对早产儿VAP的诊断率,以便及时采取治疗措施,为抢救赢得时间,降低病死率.

Objective:To analyze the clinical significance of HMGB-1 combined with PCT in the diagnosis of VAP.Method:Eighty premature infants admitted to the neonatal intensive care unit of our hospital from January 2017 to September 2019 were enrolled.The patients were divided into the premature infant VAP group(40 cases)and the premature infant non-VAP group(40 cases).The ratio of bronchial secretion HMGB-1 to blood HMGB-1 level and PCT concentration before mechanical ventilation,mechanical ventilation for 48 hours,mechanical ventilation for 96 hours,and before weaning were compared.Result:(1)The ratio of bronchial secretion HMGB-1 to blood HMGB-1 in the premature infant VAP group at 48 h and 96 h after mechanical ventilation were higher than that in the premature infant non-VAP group(P<0.05).(2)The blood PCT protein concentration in the premature infant VAP group was higher than that in the premature infant non-VAP group at 48 hours after mechanical ventilation(P<0.05).(3)The accuracy of HMGB-1 combined with PCT diagnosis was 88.75%,sensitivity was 85.00%,and specificity was 92.50%.Conclusion:HMGB-1 combined with PCT has important clinical significance in the diagnosis of premature infant VAP,and improves the diagnosis rate of premature infant VAP,so as to take timely treatment measures to win time for rescue and reduce mortality.