CEA、FDP、CRP及D-二聚体在重症社区获得性肺炎中的水平变化及其对短期预后的预测价值

Changes of CEA,FDP,CRP and D-dimer levels in patients with severe community-acquired pneumonia and their predictive value for short-term prognosis

目的探究癌胚抗原(CEA)、纤维蛋白降解产物(FDP)、C-反应蛋白(CRP)、D-二聚体(D-D)在重症社区获得性肺炎患者中的水平变化及其对患者短期预后的预测价值。方法选择2017年10月-2018年10月武警河南总队医院收治的重症社区获得性肺炎患者96例为病例组,同期在院体检健康者96例为对照组,比较两组血清CEA、FDP、CRP、D-D水平,根据96例重症社区获得性肺炎患者住院期间预后分为存活组(73例)与死亡组(23例),比较两组血清CEA、FDP、CRP、D-D水平,采用Spearman相关分析血清CEA、FDP、CRP、D-D与重症社区获得性肺炎患者住院期间死亡相关性,采用受试者工作特征曲线(ROC)分析血清CEA、FDP、CRP、D-D对重症社区获得性肺炎患者住院期间死亡的预测价值。结果病例组血清CEA、FDP、CRP、D-D水平显著高于对照组,差异有统计学意义(P<0.05);死亡组血清CEA、FDP、CRP、D-D水平显著高于存活组,差异有统计学意义(P<0.05);血清CEA、FDP、CRP、D-D与重症社区获得性肺炎患者住院期间死亡均呈正相关,差异有统计学意义(P<0.05);血清CEA、FDP、CRP、D-D联合检测对重症社区获得性肺炎患者住院期间死亡的预测价值明显优于各指标单独检测,差异有统计学意义(P<0.05)。结论CEA、FDP、CRP、D-D在重症社区获得性肺炎患者外周血中呈高水平,血清CEA、FDP、CRP、D-D联合检测对重症社区获得性肺炎患者预后具有较高的评估价值。

Objective To investigate the changes of carcinoembryonic antigen(CEA),fibrin degradation products(FDP),C-reactive protein(CRP),and D-dimer(D-D)in patients with severe community-acquired pneumonia,and analyze their predictive value for short-term prognosis.Methods 96 patients with severe community-acquired pneumonia(case group)and 96 healthy individuals(control group)in our hospital from October 2017 to October 2018 were enrolled.Case group was further divided in to two subgroups according to the prognosis during hospitalization,survival group(n=73)and death group(n=23).Serum CEA,FDP,CRP,D-D levels were compared between groups and subgroups.Spearman correlation was used to analyze the correlation between serum CEA,FDP,CRP,D-D and the death of patients with severe communityacquired pneumonia during hospitalization.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum CEA,FDP,CRP,D-D for the death of patients with severe community-acquired pneumonia during hospitalization.Results The serum CEA,FDP,CRP,D-D levels in the case group"were significantly higher than those in the control group(P<0.05);the serum CEA,FDP,CRP,D-D levels in the death group"were significantly higher than those in the survival group(P<0.05).Serum CEA,FDP,CRP,and D-D levels"were positively correlated with death rate during hospitalization in patients with severe community acquired pneumonia(P<0.05).The predictive value of combined detection of serum CEA,FDP,CRP,and D-D levels in predicting death during hospitalization of patients with severe community-acquired pneumonia"was significantly better than that of single detection(P<0.05).Conclusion CEA,FDP,CRP,D-D were highly expressed in the peripheral blood of patients with severe community-acquired pneumonia,which were significantly correlated with the prognosis of patients and,moreover,the combined detection of the four indicators had a high evaluation value for the prognosis of patients.