肺部超声评分联合CRP/SDI、PCT/SDI在预测重症细菌性肺炎患者短期预后中的价值分析OA
Analysis of the value of lung ultrasound score combined with CRP/SDI and PCT/SDI in predicting short-term prognosis of patients with severe bacterial pneumonia
目的:探讨肺部超声(Lung ultrasound,LUS)评分联合C反应蛋白(C-reactive protein,CRP)/辛普森菌群多样性指数(Simpson's diversity index,SDI)、降钙素原(Procalcitoninogen,PCT)/SDI在预测重症细菌性肺炎(Bacterial pneumonia,BP)患者短期预后中的价值.方法:选取 2020 年 12 月—2024 年 12 月在内江市第二人民医院就诊的BP患者 198 例,根据患者病情危重程度分为危重症组(124 例)和非危重症组(74 例),并以BP造成死亡为终点事件,根据患者发病后 28 天预后情况分为预后不良组(57 例)和预后良好组(141 例).比较各组LUS评分及CRP/SDI、PCT/SDI,予以单因素和COX回归分析重症BP患者短期预后不良的影响因素,并将预后不良组定义为阳性,预后良好组定义为阴性,绘制ROC曲线分析LUS评分联合CRP/SDI、PCT/SDI在预测重症BP患者短期预后中的价值.结果:较非危重症组,危重症组急性生理学与慢性健康状况评分Ⅱ(APACHE Ⅱ)、LUS评分及CRP/SDI、PCT/SDI更高(P＜0.05).较预后良好组,预后不良组LUS评分及CRP/SDI、PCT/SDI更高(P＜0.05).COX回归分析显示,LUS评分及CRP/SDI、PCT/SDI均是重症BP患者短期预后不良的危险因素(HR=3.077、1.968、1.669,P＜0.05).ROC分析显示,LUS评分联合CRP/SDI、PCT/SDI预测重症BP患者短期预后不良的AUC值为 0.942,高于各指标单独检测(0.835、0.814、0.816,P＜0.05).结论:重症BP患者APACHE Ⅱ、LUS评分及CRP/SDI、PCT/SDI更 高,LUS评分及CRP/SDI、PCT/SDI与患者短期预后不良有关,且上述指标对重症BP患者短期预后中的预测价值更高.
Objective:To investigate the value of lung ultrasound(LUS)score combined with C-reactive protein(CRP)/simp-son's diversity index(SDI)and procalcitoninogen(PCT)/SDI in predicting the short-term prognosis of patients with severe bacte-rial pneumonia(BP).Methods:A total of 198 cases of BP patients attending the Neijiang Second People's Hospital from De-cember 2020 to December 2024 were selected,and the patients were divided into the critically ill group(124 cases)and the non-critically ill group(74 cases)according to the degree of their critical condition,and the death caused by BP was used as the endpoint event,and they were classified into the group of bad prognosis(57 cases)and the group of good prognosis(141 cases)according to the prognosis of the patients at 28 days after the onset of the disease.The score of LUS,CRP/SDI and PCT/SDI were compared between two groups,and the factors influencing the short-term poor prognosis of patients with severe BP were analyzed by univariate and COX regression,and the bad prognosis group was defined as positive and the good prog-nosis group was defined as negative,and the ROC of the subjects was plotted,the AUC was obtained,the value of the score of LUS combined with CRP/SDI and PCT/SDI in predicting short-term prognosis of patients with severe BP was analyzed.Results:Compared with the non-critical group,the APACHE Ⅱ,LUS score and CRP/SDI,PCT/SDI were higher in the criti-cal group(P＜0.05).Compared with the good prognosis group,the LUS score and CRP/SDI and PCT/SDI were higher in the bad prognosis group(P＜0.05).The results of COX analyses showed that score of LUS and CRP/SDI,PCT/SDI were the risk factors for short-term poor prognosis of patients with severe BP(HR=3.077,1.968,1.669,P＜0.05).ROC analysis showed that the AUC value of LUS score combined with CRP/SDI and PCT/SDI for predicting short-term poor prognosis in patients with severe BP was 0.942,which was higher than that of each index detected separately(0.835,0.814,0.816,P＜0.05).Conclusion:APACHEⅡ,LUS score and CRP/SDI,PCT/SDI were higher in patients with severe BP,LUS score and CRP/SDI,PCT/SDI were asso-ciated with poor short-term prognosis of patients,and the predictive value of the above indicators was higher in the short-term prognosis of patients with severe BP.
钟璇;李朝玉;晏雷;李力;张雪
内江市第二人民医院,四川 内江 641000内江市第二人民医院,四川 内江 641000内江市第二人民医院,四川 内江 641000内江市第二人民医院,四川 内江 641000内江市第二人民医院,四川 内江 641000
医药卫生
肺炎,细菌性超声检查
Pneumonia,BacterialUltrasonography
《中国临床医学影像杂志》 2026 (4)
259-262,4
四川省卫生健康科研立项项目(20PJ291).
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