关键词:

重症肺炎, 降钙素原, 肝素结合蛋白, 白介素-6, 序贯器官衰竭评分, 预后

Abstract:

Objective To explore the clinical value of serum procalcitonin（PCT），heparin binding pro⁃ tein（HBP），interleukin⁃6（IL⁃6）combined with sequential organ failure assessment（SOFA）score in theprogno⁃ sis evaluation of patients with severe pneumonia. Methods A total of 173 patients with pneumonia admitted to our hospital from January 2018 to May 2021 were selected as the study subjects，and the patients were divided into the the common pneumonia group（95 cases）and the severe pneumonia group（78 cases）. During the same period， 100 healthy people in our hospital were selected as the control group. Within 24 h after admission，SOFA scores was performed for patients with pneumonia；and the level of serum PCT and IL⁃6 were detected by enzyme⁃linked immunosorbent assay，and the level of serum HBP were detected by immunofluorescence；patients withsevere pneumonia were divided into good prognosis group（n = 57）and bad prognosis group（n = 21）according to the outcome within 28 days after admission to intensive care unit（ICU），the levels of serum PCT，HBP，IL⁃6 and SOFA score in control group，common pneumonia group and severe pneumonia group were compared，and the levels of serum PCT，HBP，IL⁃6 and SOFA score were compared between good prognosis group and poor prognosis group Logistic multivariate regression analysis was used to analyze the factors related to the poor prognosis of severe pneu⁃ monia；the receiver operating characteristic（ROC）curve was used to analyze the prognostic value of PCT，HBP， IL ⁃ 6 combined SOFA score in patients with severe pneumonia. Results Compared with control group，serum PCT，HBP and IL⁃6 levels were significantly increased in common pneumonia group and severe pneumonia group （P < 0.05）；compared with common pneumonia group，the serum PCT，HBP，IL⁃6 and SOFA scores were signifi⁃ cantly increased in severe pneumonia group（P < 0.05）；compared with the good prognosis group，the serum PCT， HBP，IL⁃6 levels and SOFA score in the poor prognosis group were significantly increased（P < 0.05）；Logistic mul⁃ tivariate regression analysis showed that serum PCT，HBP and IL⁃6 were related to the occurrence of poor prognosis in patients with severe pneumonia（P < 0.05）；ROC curve analysis showed that the area under curve（ROC）of serum PCT，HBP，IL⁃6 and SPFA score in evaluating poor prognosis of severe pneumonia patients were 0.723（95% CI：0.617 ~ 0.908），0.749（95%CI：0.604 ~ 0.856），0.632（95%CI：0.514 ~ 0.780），0.774（95%CI：0.625 ~ 0.893） respectively，and the AUC of PCT，HBP，IL⁃6 combined SOFA score for poor prognosis of severe pneumonia patients were 0.915（95%CI：0.793 ~ 0.977）；combined SOFA score of serum PCT，HBP and IL⁃6 had a higher value in evaluating the prognosis of patients with severe pneumonia than the independent test of each indicator（Z = 2.276， 2.091，3.197，1.990，P < 0.05）. Conclusion The combination of serum PCT，HBP，IL⁃6 and SOFA score has a high clinical application value for the prognosis evalution of severe pneumonia patients，which may provide a refer⁃ ence for the treatment of severe pneumonia patients in clinic and reduce the incidence of poor prognosis. 

Key words:

severe pneumonia, procalcitonin, heparin binding protein, interleukin?6, sequential organ failure assessment, prognosis