PCT、APTT联合PSI评分对老年CAP严重程度评估及预测预后的价值

Value of PCT and APTT in combination with PSI score for acquired pneumonia severity assessment and prediction of prognosis in the elderly community

目的探讨血清降钙素原(PCT)、活化部分凝血酶原时间(APTT)联合肺炎严重指数(PSI)评分对评估老年社区获得性肺炎(CAP)严重程度及预测预后的价值。方法采用回顾性研究,收集2019年11月~2021年11月华北理工大学附属医院收治的118例老年CAP患者病历资料。根据重症社区获得性肺炎(SCAP)诊断标准及PSI评分,分为重症组48例、非重症组70例;重症组再根据肺炎转归情况分为死亡组14例、生存组34例。收集并分别比较各组患者入院第1、3、7d的PSI评分及血清PCT、APTT水平变化。血清PCT、APTT水平与PSI评分的相关性采用Pearson相关性分析。结果与非重症组比较,重症组患者入院1、3、7d的PSI评分及血清PCT、APTT水平均明显增高,差异有统计学意义(P<0.05);与生存组比较,死亡组患者入院1、3、7d的PSI评分及血清PCT、APTT水平均明显增高,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血清APTT、PCT水平与PSI评分均呈正相关(r=0.418、0.362,P<0.05)。结论血清PCT水平、PSI评分与老年CAP严重程度相关,且血清PCT水平与PSI评分呈正相关,即血清PCT水平、PSI评分越高提示老年重症肺炎患者预后越差;APTT与PSI评分呈正相关性,APTT延长可能会加重老年CAP严重程度及预后。

Objective To explore the value of serum calcitonogen(PCT),part of activated prothrombin time(APTT)combined with pneumonia severity index(PSI)score for the assessment and prognostic prediction of acquired pneumonia severity in the elderly community.Methods A retrospective study was used to collect the medical records of 118 elderly community-acquired pneumonia patients admitted to the Affiliated Hospital of North China University of Science and Technology between November 2019 and November 2021.According to the diagnostic criteria of severe community-acquired pneumonia(SCAP),48 cases were divided in the severe group and 70 cases in the non-severe group,and the severe group was divided into 14 deaths and 34 cases in the survival group according to the pneumonia conversion.The PSI scores,PCT,and APTT levels at numbers 1,3,and 7d of admission were compared in each group.Pearson correlation analysis was applied to analyze the correlation of PCT、APTT and PSI scores in elderly severe pneumonia.Results In the severe group,the PSI score,PCT and APTT levels were significantly higher than the non-severe group(P<0.05);in the death group,on admission day 1,3 and 7,the PSI score,PCT and APTT levels were significantly higher than the survival group(P<0.05);Pearson correlation analysis showed that APTT and PCT levels were positively associated with PSI score(r value was r=0.418,r=0.362,respectively,P<0.05).Conclusion Serum PCT level and PSI score are correlated with elderly CAP severity,and serum PCT level is positively correlated with PSI score,that is,higher serum PCT level and PSI score indicate the worse prognosis of elderly patients with severe pneumonia;APTT and PSI scores are positively correlated,and prolonged APTT may aggravate CAP severity and prognosis in older adults.