降钙素原联合BAP-65评分在慢性阻塞性肺疾病急性加重期患者预后评估中的应用价值

Value of procalcitonin combined with BAP-65 score in evaluating the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨降钙素原(PCT)联合BAP-65评分对慢性阻塞性肺疾病急性加重期(AECOPD)患者预后评估的价值。方法对131例AECOPD患者进行回顾性分析,记录入院后24 h内的血清PCT、BAP-65评分和急性生理与慢性健康评估(APACHE)Ⅱ评分。根据预后将患者分为生存组和死亡组、机械通气(MV)组和未机械通气(未MV)组,分析并比较不同组别的上述指标。比较PCT联合BAP-65评分与APACHEⅡ评分的曲线下面积(AUROC)。结果死亡组的血清PCT水平、BAP-65评分的风险等级、APACHEⅡ评分均高于生存组(均P<0.01)。与未MV组比较,MV组的血清PCT水平、BAP-65评分的风险等级、APACHEⅡ评分均较高(均P<0.01)。PCT联合BAP-65评分、APACHEⅡ评分对AECOPD患者预测院内死亡率的AUROC分别为0.822和0.839 (P>0.05),预测机械通气的AUROC分别为0.756和0.695 (P>0.05)。结论PCT联合BAP-65评分便捷、有效,可用于评估AECOPD患者的预后。

Objective To investigate the value of procalcitonin(PCT) combined with BAP-65 score in prognosis evaluation of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A retrospective analysis was performed on 131 cases of patients with AECOPD. The levels of serum PCT, BAP-65 score, acute physiology and chronic health evaluation(APACHE)Ⅱscore were recorded within 24-hour after admission to hospital. According to the prognosis, the patients were divided into survival group and death group, mechanical ventilation(MV)group and non mechanical ventilation(non-MV) group. The above indicators of different groups were analyzed and compared. The area under the curve(AUROC) of PCT combined with BAP-65 score and APACHEⅡscore(AUROC) was compared among the different groups. Results The levels of serum PCT, BAP-65 score and APACHE score in the death group were higher than those in the survival group(all P<0.01). The levels of serum PCT, BAP-65 score and APACHE Ⅱscore were higher in MV group as compared with those in the non-MV group, the differences were statistically significant(all P<0.01). The AUROC of PCT combined with BAP-65 score and APACHE Ⅱscore in predicting the mortality of AECOPD patients were 0.822 and 0.839, respectively(P>0.05).When predicting the mortality of AECOPD patients by PCT combined with BAP-65 score and APACHEⅡscore in MV group, the AUROC were 0.756 and 0.695, respectively(P>0.05).Conclusions PCT combined with BAP-65 score are convenient and practical, which can be used to evaluate the prognosis of patients with AECOPD.