降钙素原 黏蛋白 MUC5AC联合简化临床肺部感染评分对呼吸机相关性肺炎的早期诊断价值

Value of combination of procalcitonin,mucoprotein MUC5AC and simplified clinical pulmonary infection score in early diagnosis of ventilator-associated pneumonia

目的探讨降钙素原(PCT)、黏蛋白MUC5AC联合简化肺部感染评分(CPIS)对呼吸机相关性肺炎(VAP)的早期诊断价值。方法选取2018年10月至2019年9月在安徽医科大学附属安庆医院重症医学科接受机械通气治疗的78例气管插管患者作为研究对象,依据VAP诊断标准,将其分为VAP组(42例)与非VAP组(36例)。比较两组患者机械通气48 h后血清PCT、黏蛋白MUC5AC及简化CPIS评分的差异,引用受试者工作特征(ROC)曲线评价上述指标对VAP的早期诊断价值。结果VAP组患者黏蛋白MUC5AC水平为(107.21±16.36)ng/mL、PCT为(2.46±1.09)ng/mL、简化CPIS评分为(6.37±2.24)分,均高于非VAP组,差异均有统计学意义(P<0.05)。PCT、黏蛋白MUC5AC联合简化CPIS评分对早期诊断VAP的ROC曲线下面积、敏感度和特异度分别为0.962、93.32%和86.78%。结论血清PCT、黏蛋白MUC5AC及简化CPIS评分在VAP患者中均明显增高,黏蛋白MUC5AC与简化CPIS评分呈正相关,3项指标联合分析在VAP早期诊断中具有较高的价值。

Objective To explore the clinical value of the procalcitonin(PCT),mucoprotein MUC5AC and simplified clinical pulmonary infection score(CPIS)in the early diagnosis of ventilator-associated pneumonia(VAP).Methods A prospective study was conducted.During October 2018 to September 2019 in the Intensive Care Unit of Anqing Hospital of Anhui Medical University,78 patients who underwent mechanical ventilation were enrolled in this study.All subjects were divided into 42 cases in VAP group and 36 cases in non-VAP group according to the VAP diagnostic criteria.The PCT,mucin MUC5AC and simplified CPIS scores were compared between the two groups after 48 hours of mechanical ventilation.The early diagnostic value was assessed by receiver operating characteristic(ROC)curve analysis.Results The mucoprotein MUC5AC of VAP group was(107.21±16.36)ng/mL,the PCT was(2.46±1.09)ng/mL,and the simplified CPIS score was(6.37±2.24),which were all higher than those of non-VAP group,and the differences were statistically significant(P<0.05).ROC results showed that the area under curve(AUC),sensitivity and specificity of the combination of PCT,mucoprotein MUC5AC and simplified CPIS were 0.962,93.32%,86.78%,respectively.Conclusion The PCT,mucoprotein MUC5AC and simplified CPIS scores significantly increase in VAP patients.The mucoprotein MUC5AC and simplified CPIS scores have a good positive correlation.The combined analysis of the three indicators has high value in the early diagnosis of VAP.