【摘要】：目的探討營(yíng)養(yǎng)及炎性指標(biāo)對(duì)不同年齡段重癥下呼吸道感染患者近期預(yù)后的評(píng)估價(jià)值。方法選取2011年10月—2013年2月中國(guó)人民解放軍成都軍區(qū)總醫(yī)院呼吸重癥監(jiān)護(hù)病區(qū)(RICU)收治的重癥下呼吸道感染患者170例,檢測(cè)患者入院時(shí)血清降鈣素原(PCT)、超敏C反應(yīng)蛋白(hs-CRP)、清蛋白(Alb)、前清蛋白(PA)、總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、尿素氮、肌酐、血紅蛋白(Hb)水平和淋巴細(xì)胞計(jì)數(shù)(LY),運(yùn)用受試者工作特征(ROC)曲線計(jì)算曲線下面積(AUC),分析其對(duì)患者25 d死亡的預(yù)測(cè)價(jià)值。結(jié)果年齡預(yù)測(cè)25 d內(nèi)死亡的ROC曲線分析結(jié)果顯示:當(dāng)年齡為66歲時(shí),靈敏度為90.5%、特異度為37.3%、約登指數(shù)為28.2%。103例年齡≥66歲患者20例25 d內(nèi)死亡,ROC曲線分析結(jié)果顯示:PCT的AUC為0.786,其后依次為尿素氮、Alb、hs-CRP、PA、LY、LDL-C、肌酐、HDL-C、Hb、TC、TG,AUC均0.500。25 d死亡組與非死亡組的PCT、尿素氮、Alb及hs-CRP間的AUC差異有統(tǒng)計(jì)學(xué)意義(P0.05),具有獨(dú)立預(yù)測(cè)價(jià)值。67例年齡66歲患者8例25 d內(nèi)死亡,ROC曲線分析結(jié)果顯示:LDL-C的AUC為0.732,LY的AUC為0.722,其后依次為Alb、PCT、hs-CRP、TC、PA、TG、HDL-C、Hb、肌酐、尿素氮,AUC均0.500。25 d死亡組與非死亡組的LDL-C和LY的AUC差異有統(tǒng)計(jì)學(xué)意義(P0.05),具有獨(dú)立預(yù)測(cè)價(jià)值。結(jié)論炎性指標(biāo)預(yù)測(cè)年齡≥66歲的重癥下呼吸道感染患者近期預(yù)后的價(jià)值較高;營(yíng)養(yǎng)指標(biāo)預(yù)測(cè)年齡66歲患者近期預(yù)后的價(jià)值較高。不同疾病狀態(tài)、不同年齡患者應(yīng)選擇靈敏度高的預(yù)測(cè)指標(biāo)。
[Abstract]:Objective to evaluate the prognostic value of nutritional and inflammatory markers in patients with severe lower respiratory tract infection in different age groups. Methods 170 patients with severe lower respiratory tract infection were selected from October 2011 to February 2013 in (RICU) of Chengdu military region Hospital of Chinese PLA. Serum procalcitonin proto (PCT), hypersensitive C-reactive protein (hs-CRP), serum albumin (Alb), prealbumin (PA), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea nitrogen, creatinine were detected on admission. Hemoglobin (Hb) level and lymphocyte count (LY), were used to calculate the area under the curve by using the (ROC) curve of the subjects' operating characteristics. The value of (AUC), analysis in predicting the death of patients at 25 days was analyzed. Results the ROC curve analysis of age prediction within 25 days showed that when the age was 66 years old, The sensitivity was 90.5 and the specificity was 37.3. The Yorden index was 28.2.103 patients aged 鈮，

本文編號(hào)：2198194