重症社区获得性肺炎患者PIV、IL-6、HBP、PAB水平对疗效的评估价值

Evaluation values of PIV,IL-6,HBP and PAB levels in patients with severe community-acquired pneumonia

目的分析重症社区获得性肺炎(CAP)患者的泛免疫炎症值(PIV)、白细胞介素(IL)-6、肝素结合蛋白(HBP)、前白蛋白(PAB)水平变化及其对入院72 h治疗效果的评估价值。方法120例重症CAP患者(重症组)按照初始治疗效果分为有效组87例和失败组33例,另选取同期收治的非重症CAP患者120例为非重症组。比较重症组与非重症组、失败组与有效组入院次日PIV、IL-6、HBP及PAB水平,以受试者工作特征(ROC)曲线分析以上指标单独及联合检测对CAP病情及入院72 h治疗效果的评估价值。结果重症组PIV、IL-6及HBP水平高于非重症组,PAB水平低于非重症组(P<0.05);ROC曲线分析示,单独检测时PIV评估重症CAP的曲线下面积(AUC)最高,为0.830(95%CI:0.780~0.881);PIV联合IL-6、HBP及PAB评估重症CAP的AUC为0.929(95%CI:0.892~0.967),高于各单一指标检测(P<0.05)。失败组PIV、IL-6及HBP水平高于有效组,PAB水平低于有效组(P<0.05);ROC曲线分析示,单独检测时PIV评估重症CAP入院72 h治疗效果的AUC最高,为0.777(95%CI:0.692~0.862);PIV联合IL-6、HBP及PAB评估重症CAP入院72 h治疗效果的AUC为0.916(95%CI:0.846~0.986),高于各单一指标检测(P<0.05)。结论PIV联合IL-6、HBP、PAB检测对CAP患者病情及重症CAP入院72 h治疗效果评估均具有良好的价值。

Objective To analyze levels of pan-immune-inflammation value(PIV),interleukin-6(IL-6),heparin-binding protein(HBP)and prealbumin(PAB)in patients with severe community-acquired pneumonia(CAP),and their values in evaluating the therapeutic effect at 72 h after admission.Methods According to the initial(72 h)treatment outcome,120 patients with severe CAP(the severe group)were divided into the effective group(n=87)and the failed group(n=33).Meanwhile,120 patients with non-severe CAP admitted in the same period were selected as the non-severe group.PIV,IL-6,HBP and PAB levels on the day after admission were compared between the severe group,the non-severe group,the failed group and the effective group.The value of above indicators in evaluating the condition of CAP and the therapeutic effect at 72 h after admission separately and in combination were analyzed using receiver operating characteristic(ROC)curves.Results Compared with the non-severe group,there were higher PIV,IL-6 and HBP levels,and lower PAB levels in the servere grouop(P<0.05).ROC curves indicated that for evaluating severe CAP using a single indicator,the area under the curve(AUC)of PIV was the highest[0.830(95%CI:0.780-0.881)].The AUC of PIV combined with IL-6,HBP and PAB for evaluating severe CAP was 0.929(95%CI:0.892-0.967),which was higher than that of evaluation using a single indicator(P<0.05).Compared with the effective group,there were higher PIV,IL-6 and HBP levels,and lower PAB level in the failed group(P<0.05).ROC curves indicated that for evaluating the therapeutic effect on severe CAP at 72 h after admission using a single indicator the AUC of PIV was the highest[0.777(95%CI:0.692-0.862)].The AUC of PIV combined with IL-6,HBP and PAB for evaluating the therapeutic effect on severe CAP at 72 h after admission was 0.916(95%CI:0.846-0.986),which was higher than that of evaluation using a single indicator(P<0.05).Conclusion Detection of PIV combined with IL-6,HBP and PAB has a good value in evaluating the condition of patients with CAP and the therapeutic effect on severe CAP at 72 h after admission.