肺炎严重程度指数、血清Ang-2、vWF水平与EICU老年重症社区获得性肺炎患者28d预后的关系分析OA
Analysis of the relationship of pneumonia severity index,serum Ang-2,and vWF levels with 28-day prognosis in elderly patients with severe community-acquired pneumonia in the EICU
目的 分析肺炎严重程度指数(PSI)评分、血清血管生成素-2(Ang-2)、血管性血友病因子(vWF)水平与急诊重症监护病房(EICU)收治的老年重症社区获得性肺炎(CAP)患者入院后28 d预后的关联性,以期为临床决策的制定提供参考.方法 以本院2021年4月—2024年6月EICU收治的140例老年重症CAP患者为研究对象,依据患者入院后28 d预后分为预后良好组(n=78)与预后不良组(n=62).对所有研究对象进行PSI评分,并测定其血清Ang-2、vWF水平,采用lo-gistic回归分析PSI评分、血清Ang-2、vWF水平与EICU老年重症CAP患者入院后28 d预后的关联性;采用受试者工作特征(ROC)曲线分析PSI评分、血清Ang-2、vWF水平对EICU老年重症CAP患者入院后28 d预后的预测价值.结果 相比于预后良好组,预后不良组患者的PSI评分、血清Ang-2、vWF水平明显升高(P<0.05).logistic回归分析结果显示,PSI评分、血清Ang-2、vWF水平升高是EICU老年重症CAP患者入院后28 d预后的危险因素(P<0.05).ROC曲线结果显示,PSI评分、血清Ang-2、vWF水平单独及联合预测EICU老年重症CAP患者入院后28 d预后的曲线下面积(AUC)分别为0.787、0.725、0.773、0.953,敏感性分别为87.18%、82.05%、55.13%、92.31%,特异性分别为67.74%、51.61%、87.10%、88.71%,联合预测的效能优于各指标单独预测(Z=4.789、5.428、4.522,均P<0.05).结论 PSI评分、血清Ang-2、vWF水平与EICU老年重症CAP患者入院后28 d预后密切相关,早期检测上述指标可为临床干预措施的制定提供参考依据.
Objective To analyze the relationship of pneumonia severity index(PSI)score,serum angiopoietin-2(Ang-2),and von Willebrand factor(vWF)levels with the 28-day prognosis after admission in elderly patients with severe community-acquired pneumonia(CAP)admitted to the emergency intensive care unit(EICU),providing references for clinical decision-making.Methods A total of 140 elderly patients with severe CAP admitted to the EICU of our hospital from April 2021 to June 2024 were enrolled.Based on their 28-day prognosis after admission,patients were assigned to good prognosis(n=78)and poor prognosis groups(n=62).PSI scores were assessed,and serum Ang-2 and vWF levels were measured for all par-ticipants.Logistic regression analysis was used to analyze the relationship of PSI score,serum Ang-2,and vWF levels with the 28-day prognosis after admission in elderly severe CAP patients in the EICU.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of PSI score,serum Ang-2,and vWF levels for the 28-day prognosis after admission.Results Compared with the good prognosis group,the poor prognosis group had significantly higher PSI scores,serum Ang-2,and vWF levels(P<0.05).Logistic regression analysis showed that elevated PSI score,serum Ang-2,and vWF levels were risk factors for the 28-day prognosis after admission in elderly severe CAP patients in the EICU(P<0.05).ROC curve analysis indicated that the areas under the curve(AUC)for PSI score,serum Ang-2,vWF levels alone and their combination in predicting the 28-day prognosis were 0.787,0.725,0.773,and 0.953,respec-tively;the sensitivities were 87.18%,82.05%,55.13%,and 92.31%,respectively;and the specificities were 67.74%,51.61%,87.10%,and 88.71%,respectively.The predictive efficacy of the combined model was significantly superior to that of any single indicator(Z=4.789,5.428,4.522;all P<0.05).Conclusion PSI score,serum Ang-2,and vWF levels are closely correlated with the 28-day prognosis after admission in elderly severe CAP patients in the EICU.Early detection of these indicators can provide a reference basis for formulating clinical intervention strategies.
邱玥;李淑娇;康梦杰;于博轩;徐婉心;周勇;马冰新
首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038首都医科大学附属北京世纪坛医院急诊科,北京 100038
医药卫生
社区获得性肺炎预后肺炎严重程度指数血管生成素2血管性血友病因子
Community-acquired pneumoniaPrognosisPneumonia severity indexAngiopoietin-2von Willebrand factor
《保健医学研究与实践》 2026 (1)
17-22,6
北京市科技计划课题(Z221100001022043).
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