本文選題：呼吸機相關(guān)肺炎 + 血漿降鈣素原　； 參考：《廣州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討PCT、CRP和CPIS評分對呼吸機相關(guān)性肺炎(VAP)的臨床應(yīng)用價值,探討血清學(xué)指標(biāo)PCT、CRP與CPIS的相關(guān)性。方法2013年6月至2016年6月于廣州醫(yī)科大學(xué)附屬第一醫(yī)院EICU患者633例,其中需進(jìn)行有創(chuàng)機械通氣病人435例,回顧分析后187例符合VAP。收集其血液PCT、CRP以及痰培養(yǎng)等檢查,并對入組患者進(jìn)行臨床肺部感染(CPIS)評分,觀察各種因素與VAP關(guān)系,分析其預(yù)后生存。統(tǒng)計學(xué)方法采用SPSS19.0進(jìn)行統(tǒng)計學(xué)處理分析,計數(shù)資料以率(%)表示,計量資料以(?)±s表示,組間比較采用t檢驗,計數(shù)資料組間比較采用χ2檢驗,多因素分析采用多元線性回歸分析,入組后患者生存預(yù)后使用Log Rank檢驗,其中p0.05認(rèn)為差異具有統(tǒng)計學(xué)意義。結(jié)果(1)187例VAP患者中,男103例,女84例,年齡為46-101歲,平均65±12.5歲。按性別、年齡、基礎(chǔ)病因、CPIS評分分類時,各組間VAP的發(fā)生分布見表3、圖1、圖2。(2)187例VAP患者中,發(fā)現(xiàn)有159(85.0%)例患者PCT陽性(即0.5ug/L),167(89.3%)例患者CRP陽性(即10mg/L)。按感染類型、感染菌種分類時,各組間PCT,CRP的水平無明顯統(tǒng)計學(xué)差異(P0.05);以CPIS評分6分為界點,將VAP患者分組后對CRP及PCT水平進(jìn)行統(tǒng)計學(xué)分析,結(jié)果發(fā)現(xiàn),與≤6分組相比,6分組患者CRP及PCT水平明顯增高,差異具有統(tǒng)計學(xué)意義(P0.05)。(3)以CPIS評分為因變量,其余指標(biāo)為自變量進(jìn)行分析發(fā)現(xiàn),CPIS評分與PCT和CRP水平呈明顯線性正相關(guān),相關(guān)系數(shù)分別為r(PCT)=0.94,r(CRP)=0.86,P0.05。(4)對入組的187例VAP患者按照CPIS評分6分與≤6分為界限,統(tǒng)計不同患者6個月內(nèi)的生存情況,結(jié)果發(fā)現(xiàn)CPIS≤6分者生存率明顯高于6分者。X2=8.588,P=0.003。結(jié)論:(1)PCT、CRP、CPIS評分聯(lián)合評估對早期預(yù)警VAP具有一定作用。(2)CPIS評分與VAP生存率相關(guān)聯(lián),可為VAP患者臨床生存預(yù)后提供參考。
[Abstract]:Objective to investigate the clinical value of PCTU CRP and CPIS score in patients with ventilator-associated pneumonia (VAP), and to explore the correlation between serum levels of CRP and CPIS. Methods from June 2013 to June 2016, 633 EICU patients were enrolled in the first affiliated Hospital of Guangzhou Medical University, of whom 435 were required to undergo invasive mechanical ventilation. The blood levels of PCT CRP and sputum culture were collected, and the clinical pulmonary infection (CPIS) scores were evaluated. The relationship between various factors and VAP was observed, and the prognosis of the patients was analyzed. The statistical method was analyzed by SPSS 19.0, the counting data was expressed in the form of rate), the measurement data was expressed in the form of 鹵s, the comparison between groups was expressed by t test, the comparison between counting data by 蠂 2 test, and the multivariate linear regression analysis by multivariate analysis. Log Rank test was used to evaluate the survival and prognosis of the patients, and p0.05 showed that the difference was statistically significant. Results among 187 patients with VAP, 103 were male and 84 were female. The age was 46 to 101 years old (mean 65 鹵12.5 years). The occurrence and distribution of VAP in each group were as shown in Table 3, figure 1, figure 2 of 187 VAP patients according to sex, age and etiology of CPIS score. 2. Of 187 VAP patients with VAP, 159 cases were found to be PCT positive (i.e. 0.5ugr / L = 1677 + 89.3) and 10 mg / L were found to be positive for CRP (10 mg / L). According to the type of infection and the classification of infected bacteria, there was no significant difference in the level of CRP between the three groups (P 0.05), the CPIS score was divided into 6 points, and the levels of CRP and PCT were statistically analyzed after the VAP patients were divided into two groups, and the results showed that there was no significant difference in the levels of CRP and PCT between the two groups. The levels of CRP and PCT were significantly higher than those in subgroup 鈮，

本文編號：1997087