肝素结合蛋白对社区获得性肺炎诊断价值及预后评估

Study on the diagnostic and prognostic evaluation value of heparin-binding protein in community-acquired pneumonia

目的:探讨肝素结合蛋白(HBP)对社区获得性肺炎(CAP)的诊断价值和预后评估作用。方法:选取115例CAP病人,按照肺炎严重指数(PSI)评分分组,低危组<90分25例,中危组90~130分43例,高危组>130分47例,另选取同期体检健康者42例作为对照组,入院后分别进行HBP检测,并与降钙素原(PCT)、白细胞(WBC)计数指标对比,统计分析各指标组间差异。ROC曲线分析各指标对CAP诊断效能。分析HBP指标与PSI评分相关性,统计高危组CAP病人死亡及存活例数,对比HBP指标关系。结果:高危组HBP水平[(187.05±48.96)ng/mL]高于中危组[(16.80±5.34)ng/mL]、低危组[(13.49±4.87)ng/mL]、对照组(5.34±1.50)ng/mL(P<0.05),中低危组HBP差异无统计学意义(P>0.05)。HBP诊断CAP灵敏度及特异度分别为100.0%、96.7%。HBP指标与PSI呈正相关关系(P<0.05),高危组CAP病人死亡组HBP(197.65±46.75)ng/mL明显高于存活组HBP(125.43±23.76)ng/mL(P<0.01)。结论:HBP对于CAP诊断(尤其是高危组)有辅助价值,故可用于评估病情严重程度,亦作为CAP预后评估参考指标之一。

Objective:To evaluate the diagnostic and prognosis value of heparin-binding protein(HBP)in community-acquired pneumonia(CAP)patients.Methods:According to the pneumonia severity index(PSI)score,115 CAP patients were divided into the low-risk group(25 cases with<90 points),middle-risk group(43 cases with 90-130 points)and high-risk group(47 cases with>130 points).Forty-two healthy people were set as the control group.The heparin-binding protein(HBP)in all cases were tested after admission,which were compared and analyzed with the procalcitonin(PCT)and white blood cell(WBC).The ROC curve was used to analyze the diagnostic efficacy of each index to CAP.The correlation between HBP index and PSI score was analyzed,the number of death and survival cases in the high risk group were counted,and which was compared with HBP index.Results:The HBP level in high-risk group[(187.05±48.96)ng/mL]were higher than that in middle-risk group[(16.80±5.34)ng/mL],low-risk group[(13.49±4.87)ng/mL]and control group[(5.34±1.50)ng/mL],the differences of HBP level between high-risk group and other groups were statistically significant(P<0.05),and the difference of HBP level between middle and low risk groups was not statistically significant(P>0.05).The diagnostic sensitivity and specificity of heparin binding protein were 100.0%and 96.7%,respectively.The HBP indicators were positively correlated with PSI(P<0.05).In the high-risk group,the HBP levels in death group[(197.65±46.75)ng/mL]was significantly higher than that in survival group[(125.43±23.76)ng/mL](P<0.01).Conclusions:The HBP is of auxiliary value in the diagnosis of CAP(especially in high-risk group),so it can be used to evaluate the severity of the disease.It is also one of the reference index for the prognosis evaluation of CAP.