老年卧床继发多重耐药菌重症肺炎患者血清CRP、PCT水平与预后的关系

Relationship between serum CRP,PCT,and prognosis in elderly bedridden patients with severe pneumonia secondary to multidrug-resistant bacteria

目的回顾性分析老年卧床继发多重耐药菌重症肺炎患者血清C反应蛋白(CRP)、降钙素原(PCT)水平与预后的关系。方法回顾性选取2020年3月—2022年10月首都医科大学附属北京世纪坛医院收治的128例老年卧床继发多重耐药菌重症肺炎患者纳入研究组,另选取130例同期收治的未合并多重耐药菌感染的老年重症肺炎患者纳入对照组。根据临床肺部感染评分(CPIS)将研究组患者按照病情严重程度分为严重组(38例)和一般组(90例);根据治疗3个月后预后情况将研究组患者分为预后良好组(100例)和预后不良组(28例)。比较研究组与对照组患者及研究组患者中不同病情严重程度和不同预后情况患者的血清CRP、PCT水平,统计3个月后研究组患者预后情况,采用二元Logistic回归分析影响老年卧床继发多重耐药菌重症肺炎患者预后的因素。结果研究组患者血清CRP及PCT水平均高于对照组,差异均有统计学意义(P<0.05)。病情严重组患者血清CRP、PCT水平均高于一般组,差异均有统计学意义(P<0.05)。预后良好组与预后不良组患者的机械通气时间、体温比较,差异无统计学意义(P>0.05)。预后良好组与预后不良组患者的年龄、氧合指数、病原菌类型、血清CRP及PCT水平比较,差异均有统计学意义(P<0.05)。二元Logistic回归分析结果显示,年龄、氧合指数、病原菌类型、CRP及PCT水平是老年卧床继发多重耐药菌重症肺炎患者预后的影响因素(P<0.05)。结论年龄、氧合指数、病原菌类型、血清CRP及PCT水平是老年卧床继发多重耐药菌重症肺炎患者预后的影响因素,其中血清CRP及PCT水平可以作为评估该疾病病情严重程度的重要指标,具有临床意义。

Objective This study aimed to retrospectively analyze the relationship between serum C-reactive protein(CRP),procalcitonin(PCT),and prognosis in elderly bedridden patients with severe pneumonia secondary to multidrug-resistant bacteria(MDRB).Methods A retrospective analysis was conducted on 128 elderly bedridden patients diagnosed with severe pneumonia secondary to MDRB at Beijing Shijitan Hospital from March 2020 to October 2022.An additional 130 elderly pa-tients with severe pneumonia without MDRB were included as a control group.Based on the Clinical Pulmonary Infection Score(CPIS),the study group was further divided into a severe group(38 cases)and a general group(90 cases).According to the prognosis after three months,the study group was categorized into a good prognosis group(n=100)and a poor prog-nosis group(n=28).The serum levels of CRP and PCT were compared between the study and control groups,and among patients with different severity levels and prognosis in the study group.Prognosis after three months was statistically ana-lyzed,and binary logistic regression was used to identify factors influencing the prognosis of elderly bedridden patients with severe pneumonia secondary to MDRB.Results The serum levels of CRP and PCT in the study group were significantly higher than those in the control group(P<0.05).The severe group exhibited significantly higher serum CRP and PCT lev-els compared to the general group(P<0.05).No significant differences were found in mechanical ventilation duration and body temperature between the good and poor prognosis groups(P>0.05).However,significant differences were observed in age,oxygenation index,pathogen type,and serum levels of CRP and PCT between the two prognosis groups(P<0.05).Binary logistic regression analysis indicated that age,oxygenation index,pathogen type,and serum levels of CRP and PCT were factors influencing the prognosis of elderly bedridden patients with severe pneumonia secondary to MDRB(P<0.05).Conclusion Age,oxygenation index,pathogen type,and serum levels of CRP and PCT are influencing factors in the prog-nosis of elderly bedridden patients with severe pneumonia secondary to MDRB.Serum levels of CRP and PCT can serve as important indicators for assessing the severity of this disease,demonstrating clinical significance.