IL-6、PCT、CRP对老年肺部感染患者预后评价的价值及最佳截断值分析

Value of IL-6,PCT and CRP in the Prognosis Evaluation of Elderly Patients with Pulmonary Infection and the Analysis of the Optimal Cutoff Value

目的探讨白介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)对老年肺部感染患者预后评价的价值及最佳截断值。方法回顾性分析我院2017年1月—2018年11月收治的214例老年肺部感染患者的临床资料。所有患者均接受常规治疗,统计患者一般资料,分析住院期间(2个月以内)预后及影响预后的危险因素,判断血清IL-6、PCT、CRP与老年肺部感染患者预后的关系及三者对患者死亡的预测价值。结果214例患者住院期间存活率为78.97%(169/214)。白细胞数、金黄色葡萄球菌感染、IL-6、PCT和CRP水平是老年肺部感染患者预后不良的独立危险因素(P<0.05)。IL-6、PCT、CRP对老年肺部感染患者预后不良均有一定预测价值,曲线下面积分别为0.818、0.876、0.828,预测不良预后的最佳截断值分别为28.23 pg/ml、6.68μg/L、11.82 mg/L。结论IL-6、PCT、CRP联合检测对评估老年肺部感染患者预后具有重要参考价值,临床中应引起重视。

Objective To study the value of interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CRP)in evaluating the prognosis of elderly patients with pulmonary infection and the optimal cutoff value.Methods A retrospective analysis was conducted on 214 elderly patients with pulmonary infection admitted to our hospital from January 2017 to November 2018.All the patients received conventional treatment.The general data of patients were collected,and the prognosis during hospitalization(within 2 months)and influencing factors of the prognosis were analyzed.The relationship between serum IL-6,PCT,CRP and the prognosis of elderly patients with pulmonary infection was judged,and the predictive value of serum IL-6,PCT,CRP to the death of patients was analyzed.Results During the hospitalization period(within 2 months),169 patients survived,accounting for 78.97%(169/214).In addition to leukocytes and Staphylococcus aureus,IL-6,PCT and CRP were also independent risk factors for poor prognosis in elderly patients with pulmonary infection(P<0.05).IL-6,PCT and CRP had a certain predictive value for the poor prognosis of the elderly patients with pulmonary infection.The area under the curve was 0.818,0.876 and 0.828,respectively,and the optimal cutoff values for predicting the poor prognosis were 28.23 pg/ml,6.68μg/L and 11.82 mg/L respectively.Conclusion The combined detection of IL-6,PCT and CRP has an important reference value in evaluating the prognosis of elderly patients with pulmonary infection,which should be paid more attention in clinical practice.