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降钙素原对慢性阻塞性肺疾病急性加重患者无创正压通气的预测价值。

The predictive value of serum procalcitonin for non-invasive positive pressure ventilation in the patients with acute exacerbation of chronic obstructive pulmonary disease.

机构信息

Department of Respiratory and Critical Care Medicine.

Department of Specialist Care, Harrison International Peace Hospital, Hengshui, Hebei, China.

出版信息

Medicine (Baltimore). 2021 Apr 23;100(16):e25547. doi: 10.1097/MD.0000000000025547.

Abstract

This study aimed to estimate the value of serum procalcitonin (PCT) for non-invasive positive pressure ventilation (NIPPV) prediction in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).A total of 220 AECOPD patients were divided into NIPPV group (n = 121) and control group (routine treatment, n = 99) based on the routine standards and physicians' experience. Logistic regression analysis was performed to identify the independent factors for NIPPV treatment. Additionally, the predictive values of the factors were measured through receiver operation characteristic (ROC) curve.NIPPV group and control group showed significant differences in respiratory rate (RR), PaO2, PaCO2, pH, oxygenation index, erythrocyte sedimentation rate (ESR), neutrophil, CRP (C-reaction protein), and PCT (P < .05 for all). PCT, CRP, PaCO2, RR, and neutrophil were independently correlated with NIPPV treatment in AECOPD. ROC curve showed that PCT had superior predictive value, with AUC of 0.899, the sensitivity of 86%, and the specificity of 91.9%. The cut-off value of serum PCT for NIPPV prediction was 88.50 ng/l.AECOPD patients who require NIPPV treatment frequently have high levels of PCT, CRP, PaCO2, RR and neutrophil. Serum PCT may be employed as an indicator for NIPPV treatment in AECOPD patients.

摘要

本研究旨在评估血清降钙素原(PCT)在慢性阻塞性肺疾病急性加重(AECOPD)患者中用于无创正压通气(NIPPV)预测的价值。

根据常规标准和医生的经验,将 220 例 AECOPD 患者分为 NIPPV 组(n=121)和对照组(常规治疗,n=99)。采用逻辑回归分析确定 NIPPV 治疗的独立因素。此外,通过受试者工作特征(ROC)曲线测量因素的预测值。

NIPPV 组和对照组在呼吸频率(RR)、PaO2、PaCO2、pH、氧合指数、红细胞沉降率(ESR)、中性粒细胞、C 反应蛋白(CRP)和 PCT 方面均存在显著差异(所有 P<.05)。PCT、CRP、PaCO2、RR 和中性粒细胞与 AECOPD 中的 NIPPV 治疗独立相关。ROC 曲线显示 PCT 具有较高的预测价值,AUC 为 0.899,灵敏度为 86%,特异性为 91.9%。预测 NIPPV 治疗的血清 PCT 截断值为 88.50ng/L。

需要 NIPPV 治疗的 AECOPD 患者通常 PCT、CRP、PaCO2、RR 和中性粒细胞水平较高。血清 PCT 可作为 AECOPD 患者 NIPPV 治疗的指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b8/8078461/c9d585266a49/medi-100-e25547-g001.jpg

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