Prognostic value of serum procalcitonin combined with extravascular lung water index in patients with acute respiratory distress syndrome caused by severe community-acquired pneumonia

Huang Yunfeng; Zhou Fan; Xu Xiaolin

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Prognostic value of serum procalcitonin combined with extravascular lung water index in patients with acute respiratory distress syndrome caused by severe community-acquired pneumonia

更新时间：2021-08-23

- Prognostic value of serum procalcitonin combined with extravascular lung water index in patients with acute respiratory distress syndrome caused by severe community-acquired pneumonia
- Health Medicine Research and Practice Vol. 17, Issue 4, Pages: 37-40(2020)
- 作者机构：
  
  1. 湖北省黄冈市中心医院急诊医学科
  2. 湖北省黄冈市中心医院全科医学科
  3. 湖北省黄冈市中心医院保健科
- 作者简介：
- 基金信息：
- DOI：
  CLC： R563.1;R563.8
- Published：2020，
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[1]黄云峰,周帆,徐晓林.血清降钙素原联合血管外肺水指数在重症社区获得性肺炎致急性呼吸窘迫综合征患者预后评估中的价值[J].保健医学研究与实践,2020,17(04):37-40.

Huang Yunfeng, Zhou Fan, Xu Xiaolin. Prognostic value of serum procalcitonin combined with extravascular lung water index in patients with acute respiratory distress syndrome caused by severe community-acquired pneumonia. [J]. Health Medicine Research and Practice 17(4):37-40(2020)
[1]黄云峰,周帆,徐晓林.血清降钙素原联合血管外肺水指数在重症社区获得性肺炎致急性呼吸窘迫综合征患者预后评估中的价值[J].保健医学研究与实践,2020,17(04):37-40. DOI：

Huang Yunfeng, Zhou Fan, Xu Xiaolin. Prognostic value of serum procalcitonin combined with extravascular lung water index in patients with acute respiratory distress syndrome caused by severe community-acquired pneumonia. [J]. Health Medicine Research and Practice 17(4):37-40(2020) DOI：

摘要

目的探讨血清降钙素原（PCT）联合血管外肺水指数（EVLWI）在重症社区获得性肺炎（SCAP）致急性呼吸窘迫综合征（ARDS）患者预后评估中的价值。方法回顾性分析2015年1月-2019年1月在黄冈市某医院急诊医学科住院治疗的57例SCAP致ARDS患者病例资料

根据其预后不同分为死亡组（25例）和存活组（32例）

比较2组患者入院时白细胞（WBC）计数、C反应蛋白（CRP）、PCT、中心静脉压（CVP）、平均动脉压（MAP）、心脏指数（CI）、全身血管阻力指数（SVRI）、全心舒张末期容积指数（GEDVI）、氧合指数（OI）、EVLWI等指标

采用Logistic回归分析SCAP致ARDS患者死亡的独立危险因素

采用受试者工作特征（ROC）曲线分析PCT联合EVLWI评估SCAP致ARDS患者预后的临床价值。结果死亡组患者入院时血清PCT水平及EVLWI分别为（26.79±7.01）ng/m L及（11.45±2.55）m L/kg

明显高于存活组的（7.87±2.72）ng/m L及（7.91±1.37）m L/kg

（均P<0.05）;而死亡组患者入院时OI为（140.51±18.79）mm Hg（1mm Hg=0.133k Pa）

低于存活组的（159.14±20.35）mm Hg（P<0.05）。2组患者入院时的WBC计数

CRP

CVP

MAP

SVRI及GEDVI等指标比较

差异均无统计学意义（P>0.05）。Logistic回归分析结果显示

血清PCT水平、EVLWI升高为SCAP致ARDS患者死亡的独立危险因素（P<0.05）。PCT联合EVLWI评估SCAP致ARDS患者预后的敏感度、特异度、曲线下面积（AUC）分别为91.67%

90.91%及0.917

均高于采用PCT或EVLWI单一指标的数据。结论 PCT及EVLWI评估SCAP致ARDS患者预后的临床价值明显优于其他指标

尤其二者联合可明显提高预后评估的准确度。

Abstract

Objective Toexploretheprognosticvalueofserumprocalcitonin（PCT）combinedwithextravascularlung water index（EVLWI） in patients with acute respiratory distress syndrome（ARDS） caused by severe com-munity-acquired pneumonia（SCAP）. Methods A retrospective analysis of the data of 57 SCAP-induced ARDS patients who were hospitalized in the emergency medicine department of a hospital in Huanggang from January 2015 to January 2019 was conducted. The patients were divided into death group（25 cases） and survival group（32 cases） according to their prognosis. The two groups were compaered in terms of white blood cell（WBC） count

C-reactive protein（CRP）

PCT

central venous pressure（CVP）

mean arterial pressure（MAP）

cardiac index（CI）

systemic vascular resistance index（SVRI）

global end diastolic volume index（GEDVI）

EVLWI

oxygenation index（OI） and other indicators on admission. Logistic regression analysis was used to analyze the independent risk factors for death of SCAP-induced ARDS patients

and the receiver operating characteristic（ROC） curve was used to analyze the prognostic value of PCT combined with EVLWI in SCAP-induced ARDS patients. Results The serum PCT level and EVLWI of the patients in the death group on admission were（26.79±7.01）ng/m Land（11.45±2.55）m L/kg

respectively

significantly higher than those of the survival group

which were（7.87±2.72）ng/m Land（7.91±1.37） m L/kg

respectively（all P<0.05）. The OI of pa-tients in the death group was（140.51±18.79） mm Hg（1 mm Hg=0.133 k Pa） on admission

which was lower than the（159.14±20.35）mm Hg of the survival group（P<0.05）. There was no statistically significant differ-ence in WBC count

CRP

CVP

MAP

SVRI and GEDVI between the two groups on admission（P >0.05）. Logistic regression analysis showed that the increase of serum PCT level and EVLWI were independent risk factors for death of SCAP-induced ARDS patients（P<0.05）. The sensitivity

specificity and area under the curve（AUC） of PCT combined with EVLWI in the prognosis of SCAP-induced ARDS patients were 91.67%

90.91%

and 0.917

respectively

better than using PCT or EVLWI alone. Conclusion The prognostic value of PCT and EVLWI in SCAP-induced ARDS patients are significantly better than other indicators

and the combina-tion of the two can significantly improve the accuracy of prognostic evaluation.

关键词

降钙素原血管外肺水指数社区获得性肺炎急性呼吸窘迫综合征

Keywords

ProcalcitoninExtravascular lung water indexCommunity-acquired pneumoniaAcute respiratory distress syndrome

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