CPIS评分联合PCT对老年社区获得性肺炎患者预后的评估价值

The Evaluation Value of CPIS Score Combined with PCT on the Prognosis of Elderly Patients with Community-acquired Pneumonia

目的探讨临床肺部感染评分(CPIS)联合降钙素原(PCT)对老年社区获得性肺炎(CAP)患者预后的评估价值。方法选择2018年1月~2019年6月北京市通州区中西医结合医院内科住院的老年CAP患者169例,根据临床转归分成死亡组(37例)和生存组(132例),比较两组血清PCT水平、白细胞计数(WBC)、CPIS评分和APACHEⅡ评分,分析CPIS评分、血清PCT水平、APACHEⅡ评分、PCT和CPIS评分联合预测老年CAP患者死亡的价值。结果死亡组CPIS评分、APACHEⅡ评分和血清PCT水平均高于存活组,差异有统计学意义(P<0.05);两组WBC比较,差异无统计学意义(P>0.05);ROC曲线分析显示,PCT、CPIS评分、APACHEⅡ评分及PCT联合CPIS评分预测患者死亡的AUC分别为0.715、0.801、0.896、0.838,其中APACHEⅡ评分预测患者死亡的AUC大于PCT、CPIS评分,差异有统计学意义(P<0.05),PCT联合CPIS评分预测患者死亡的AUC与APACHEⅡ评分比较,差异无统计学意义(P>0.05)。结论血清PCT联合CPIS评分预测老年CAP患者预后的临床价值与APACHEⅡ评分相近,对评估患者预后具有良好的应用价值。

Objective To explore the value of clinical pulmonary infection score(CPIS)combined with procalcitonin(PCT)in evaluating the prognosis of elderly patients with community-acquired pneumonia(CAP).Methods A total of 169 elderly CAP patients who were hospitalized in the Department of Internal Medicine,Tongzhou District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing from January 2018 to June 2019,were divided into death group(37 cases)and survival group(132 cases)according to their clinical outcomes,and the two groups were compared.Serum PCT level,white blood cell count(WBC),CPIS score and APACHEⅡ score,analysis of the value of CPIS score,serum PCT level,APACHEⅡ score,PCT and CPIS score in predicting the death of elderly CAP patients.Results The CPIS score,APACHEⅡ score,and serum PCT levels in the death group were higher than those in the survival group,the difference was statistically significant(P<0.05);the difference between the two groups of WBC was not statistically significant(P>0.05);ROC curve analysis showed that PCT,CPIS score,APACHEⅡ score,and PCT combined CPIS score predicted death of patients with AUC of 0.715,0.801,0.896,0.838,respectively,APACHEⅡ score predicted patient death AUC greater than PCT,CPIS score,the difference was statistically significant(P<0.05)There was no statistically significant difference between the AUC and APACHEⅡ scores of PCT combined with CPIS score for predicting patient death(P>0.05).Conclusion The clinical value of serum PCT combined with CPIS score in predicting the prognosis of elderly CAP patients was similar to the APACHEⅡ score,and had a good application value in evaluating the prognosis of patients.