血清PCT、CRP和IDO水平在预测社区获得性肺炎患者预后中的临床价值

李群; 吕允相; 夏申宏; 李子广; 张永; 邵璐

doi:10.16766/j.cnki.issn.1674-4152.003426

血清PCT、CRP和IDO水平在预测社区获得性肺炎患者预后中的临床价值

doi: 10.16766/j.cnki.issn.1674-4152.003426

李群^1, ,,
吕允相²,
夏申宏¹,
李子广¹,
张永²,
邵璐¹

1.
蚌埠医学院第二附属医院呼吸与危重症医学科，安徽蚌埠 233000
2.
蚌埠医学院第一附属医院呼吸与危重症医学科，安徽蚌埠 233004

基金项目:

安徽省重点研究与开发计划项目 1804h08020287

详细信息

通讯作者:
李群，E-mail：qunli7505@163.com

中图分类号: R563.1 R446.11
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- 被引次数: 0
出版历程
- 收稿日期: 2023-07-21
- 网络出版日期: 2024-05-27

Clinical value of serum PCT, CRP and IDO levels in predicting prognosis in patients with community-acquired pneumonia

1.
Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

摘要: 目的探讨社区获得性肺炎(CAP)患者血清降钙素原(PCT)、C-反应蛋白(CRP)和吲哚胺2, 3二氧化酶(IDO)水平的临床意义。方法研究纳入2019年10月—2021年9月蚌埠医学院第二附属医院100例诊断明确的CAP患者和符合标准的40例健康体检者。根据CURB-65评分，将CAP患者分为低危组(38例)、中危组(32例)和高危组(30例)，健康者为对照组(40例)。检测患者和健康者血清PCT、CRP和IDO水平，分析它们之间的相关性，应用血清PCT和IDO水平预测患者死亡率。结果与健康者比较，CAP患者血清中PCT、CRP、IDO水平显著升高(P < 0.001);与中危组比较，高危组CAP患者血清PCT、CRP、IDO水平显著升高(P < 0.001);低危组患者血清PCT、CRP、IDO水平显著低于中危组和高危险组(P < 0.001)。血清IDO水平与CURB-65评分呈正相关关系(r=0.750，P < 0.001);血清IDO水平与PCT、CRP水平呈正相关关系(r=0.724，P < 0.001;r=0.634，P < 0.001)。PCT联合IDO预测CAP患者28 d入住ICU率或死亡率显著升高(AUC=0.913，P < 0.05)。结论 CAP患者血清中PCT、CRP、IDO水平显著升高，血清IDO水平与CURB-65评分、血清PCT、CRP水平呈正相关关系，血清PCT联合IDO水平预测28 d入住ICU率或死亡率更准确。
- 社区获得性肺炎 /
- 降钙素原 /
- C反应蛋白 /
- 吲哚胺2, 3二氧化酶
Abstract: Objective To investigate the clinical value of serum levels of procalcitonin (PCT), C-reactive protein (CRP) and indoleamine 2, 3-dioxygenase (IDO) in patients with community-acquired pneumonia (CAP). Methods A total of 100 patients with a definite diagnosis of CAP and 40 healthy subjects were enrolled in the Second Affiliated Hospital of Bengbu Medical College from October 2019 to September 2021. According to CURB-65 criteria, patients with CAP were allocated into three groups: the low-risk group (38 cases), the moderate-risk group (32 cases), and the high-risk group (30 cases). Healthy subjects were served as the control group (40 cases). Serum PCT, CRP and IDO levels of all subjects were measured, and assessed their correlation. Serum PCT and IDO levels were applied to predict patient mortality. Results Serum levels of PCT, CRP and IDO in patients with CAP significantly increased compared to that of control subjects (P < 0.001). Additionally, serum PCT, CRP and IDO levels of patients with CAP in the high-risk group were significantly elevated relative to that in the moderate-risk group (P < 0.001). Meanwhile, serum PCT, CRP and IDO levels of patients with CAP in the low-risk group were significantly decreased compared with that in moderate-risk group and high-risk group (P < 0.001). Serum IDO levels were positively correlated with CURB-65 score (r=0.750, P < 0.001). Serum IDO levels were positively correlated with PCT and CRP levels (r=0.724, P < 0.001; r=0.634, P < 0.001). PCT combined with IDO predicted a significantly higher 28-day ICU admission rate or mortality in CAP patients (AUC=0.913, P < 0.05). Conclusion Serum levels of PCT, CRP and IDO are significantly increased in patients with CAP. Serum IDO levels is positive correlation with CURB-65 score, serum levels of PCT and CRP. Serum PCT combined with IDO levels predicted 28-day ICU admission rate or mortality is more accurately.
- Community-acquired pneumonia /
- Procalcitonin /
- C-reactive protein /
- Indoleamine 2, 3-dioxygenase

HTML全文

图 1 血清IDO、CRP和PCT及联合IDO和PCT预测28 d入住ICU或死亡率的ROC曲线

Figure 1. ROC curves for serum IDO, CRP, and PCT individually, as well as their combination, in predicting the ICU admission or mortality rate at 28 days

下载: 全尺寸图片幻灯片

表 1 对照组与CAP组患者血清PCT、CRP和IDO水平比较[M(P₂₅, P₇₅)]

Table 1. Comparision of serum levels of CPT, CRP, and IDO between the control group and patients in the CAP group[M(P₂₅, P₇₅)]

组别	例数	PCT(ng/mL)	CRP(mg/mL)	IDO(ng/mL)
对照组	40	0.06(0.05, 0.09)	4.00(3.00, 6.00)	3.89(2.02, 5.44)
CAP组	100	1.20(0.67, 2.45)	22.12(13.10, 42.03)	48.72(39.19, 62.23)
Z值		-9.227	-8.767	-9.226
P值		< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 2 3组CAP患者血清PCT、CRP和IDO水平比较[M(P₂₅, P₇₅)]

Table 2. Comparision of serum levels of CPT, CRP, and IDO among patients in three CAP groups[M(P₂₅, P₇₅)]

组别	例数	PCT(ng/mL)	CRP(mg/mL)	IDO(ng/mL)
低危组	38	0.64(0.56, 0.80)	37.18(30.56, 43.48)	12.41(7.92, 17.37)
中危组	32	1.19(1.06, 1.55)	51.54(42.18, 61.81)	21.70(13.95, 32.91)
高危组	30	3.97(2.86, 6.11)	72.33(58.39, 92.44)	45.15(40.22, 53.79)
H值		74.650	65.093	54.616
P值		< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 3 CAP患者血清IDO、CRP和PCT水平预测28 d ICU入住率或死亡率

Table 3. Serum IDO, CRP, and PCT levels in patients with CAP predicted 28-day ICU occupancy or mortality

项目	AUC	SE	AUC的95% CI
PCT	0.893	0.035	0.825~0.961
IDO	0.860	0.042	0.777~0.944
CRP	0.843	0.039	0.767~0.919
IDO+PCT	0.913	0.033	0.849~0.977

下载: 导出CSV

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