动态监测C反应蛋白评估重症社区获得性肺炎疗效和预后临床研究.docVIP

动态监测C反应蛋白评估重症社区获得性肺炎疗效和预后临床研究 　　[摘要]目的 探讨动态监测C反应蛋白在评估重症社区获得性肺炎疗效和预后中的应用价值。方法 选取2014年3月～2016年1月在我院ICU治疗的62例重症社区获得性肺炎患者作为研究对象，按出院时结局分为死亡组（17例）和存活组（45例），比较两组的C反应蛋白（CRP）、白细胞（WBC）、降钙素原（PCT）、序贯器官衰竭估计（SOFA）评分、C反应蛋白比率（CRP-ratio）及相关指标。结果 死亡组的急性生理与慢性健康（APACHE Ⅱ）评分、死亡风险系数、降钙素原值及SOFA评分均高于存活组，差异有统计学意义（P0.05）。CRP、PCT、SOFA均可对疗效及预后进行评估，但CRP-ratio敏感度更高，差异有统计学意义（P0.05）。结论 CRP-ratio较PCT及SOFA评分敏感度更高，可于抗感染治疗的第3天对治疗效果及预后进行有效评估。 　　[关键词]动态监测；C反应蛋白；重症社区获得性肺炎；疗效；预后 　　[中图分类号] R563.1+9 [文献标识码] A [文章编号] 1674-4721（2016）10（a）-0022-04 　　[Abstract]Objective To explore the application value of dynamic monitoring of C reactive protein in evaluating the curative effect and prognosis of severe community acquired pneumonia.Methods 62 patients with serious community acquired pneumonia from March 2014 to January 2016 in the ICU at our hospital were selected and divided into the death group and the survivors group according to the ending when discharged.The death group was 17 cases，the survivors group was 45 cases.The level of C reactive protein （CRP），white blood cell （WBC） and procalcitonin （PCT），sequential organ failure assessment （SOFA） score，C reactive protein ratio （CRP-ratio） and the relevant indexes was compared between the two groups respectively.Results The acute physiology and chronic health（APACHE Ⅱ） score，the risk factor of death，the original value of calcitonin and SOFA score of the death group was greater than that the survivors group，there was statistical significance （P0.05）.The CRP，PCT and SOFA was able to assessed the effect and prognosis，but the sensibility of CRP-ratio was higher，there was statistical significance （P0.05）.Conclusion The CRP-ratio has higher sensibility that compared with the PCT and SOFA，which can assess the treatment effect and prognosis on the 3rd day of anti-infective therapy. 　　[Key words]Dynamic monitoring；C reactive protein；Serious community acquired pneumonia；Treatment effect；Prognosis 　　重症社区获得性肺炎（serious community acquired pneumonia，SCAP）是一种常见的重症学科呼吸道疾病，具