降钙素原、C 反应蛋白、髓系细胞触发受体-1 可溶性和临床肺部感染评分对评估老年社区获得性肺炎严重程度及预后的价值。

The usefulness of serum procalcitonin, C-reactive protein, soluble triggering receptor expressed on myeloid cells 1 and Clinical Pulmonary Infection Score for evaluation of severity and prognosis of community-acquired pneumonia in elderly patients.

机构信息

Department of Gerontology, Shanghai No.5 Hospital, Fudan University, Shanghai, 200240, China.

出版信息

Arch Gerontol Geriatr. 2019 Jan-Feb;80:53-57. doi: 10.1016/j.archger.2018.10.005. Epub 2018 Oct 12.

DOI:10.1016/j.archger.2018.10.005

PMID:30366226

Abstract

AIMS

To comparatively analyze the usefulness of serum procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) and Clinical Pulmonary Infection Score (CPIS) for assessing the severity and prognosis of community-acquired pneumonia (CAP) in the elderly.

METHODS

A total of 214 elderly patients with CAP and 106 healthy persons were enrolled in this prospective study. On the admission day, serum inflammatory markers, including CRP, PCT, sTREM-1, and CPIS were analyzed. By severity, the CAP patients were subdivided into non-severe CAP group and severe CAP group. By outcome, the patients were classified into survival group and death group. The efficiency of three inflammatory markers and CPIS on predicting prognosis of pneumonia patients was then analyzed.

RESULTS

The serum inflammatory markers and CPIS were significantly higher in CAP patients than in healthy controls. These biomarkers and CPIS were significantly higher in patients with severe CAP than in patients with non-severe CAP. Compared with patients who would survive, these markers and CPIS were significantly higher in patients who would die. Receiver operating characteristic curve analysis showed that the area under the curve and sensitivity were higher for serum sTREM-1 than for other indicators, while the specificity of serum PCT was the highest.

CONCLUSIONS

Serum CRP, PCT, and sTREM-1 and CPIS determined on the admission day are effective indicators to evaluate the severity and prognosis of CAP in the elderly. The prognostic value of PCT and sTREM-1 is better than that of CRP and CPIS.

摘要

目的

比较分析血清降钙素原（PCT）、C 反应蛋白（CRP）、髓系细胞触发受体 1 可溶性（sTREM-1）和临床肺部感染评分（CPIS）在评估老年社区获得性肺炎（CAP）严重程度和预后中的作用。

方法

前瞻性研究纳入 214 例老年 CAP 患者和 106 例健康对照者。入院当天，分析血清炎症标志物，包括 CRP、PCT、sTREM-1 和 CPIS。根据严重程度，将 CAP 患者分为非重症 CAP 组和重症 CAP 组。根据结局，将患者分为存活组和死亡组。然后分析三种炎症标志物和 CPIS 对预测肺炎患者预后的效率。

结果

与健康对照组相比，CAP 患者的血清炎症标志物和 CPIS 明显升高。与非重症 CAP 患者相比，重症 CAP 患者的这些标志物和 CPIS 明显升高。与存活患者相比，死亡患者的这些标志物和 CPIS 明显升高。受试者工作特征曲线分析显示，血清 sTREM-1 的曲线下面积和敏感性均高于其他指标，而血清 PCT 的特异性最高。