摘要
目的:探究和肽素、乳酸及D-二聚体对呼吸机相关性肺炎预后的影响。方法:选取2015年5月-2016年12月本院收入ICU并行机械通气的患者67例,其中发生呼吸机相关性肺炎(VAP)的患者27例,作为VAP组,其余40例患者作为非VAP组。动态监测两组患者的血和肽素、乳酸及D-二聚体水平,根据APACHEⅡ评分系统对VAP组患者危重程度进行评分,分析上述三项指标与VAP患者APACHEⅡ评分及预后的关系,并计算三项指标的灵敏度和特异度。结果:VAP组插管48、72、96、120 h的和肽素、乳酸及D-二聚体水平均高于非VAP组,差异均有统计学意义(P<0.05)。死亡组患者的和肽素、乳酸、D-二聚体及APACHEⅡ评分均高于存活组,差异均有统计学意义(P<0.05)。和肽素、乳酸、D-二聚体均具有较好的灵敏度和特异度。结论:和肽素、乳酸及D-二聚体对呼吸机相关性肺炎及其预后都有较好的提示作用,具有重要的临床应用价值。
Objective： To explore the effects of copeptin, lactic acid and D-dimer on the prognosis of ventilator associated pneumonia.Method： A total of 67 patients were enrolled in the ICU parallel mechanical ventilation in our hospital from May 2015 to December 2016, 27 patients with ventilator-associated pneumonia （ VAP ） were selected as the VAP group, the remaining 40 patients were selected as the non-VAP group.The levels of blood copeptin, lactic acid and D-dimer were measured in the two groups, the criticality of VAP group was scored according to APACHE 11 scoring system, the relationship between the above three indexes and the APACHE Ⅱ score and prognosis of VAP patients was analyzed and the sensitivity and specificity of the three indexes were calculated.Result： At 48, 72, 96, 120 h of intubation, the levels of copeptin, lactic acid and D-dimer of VAP group were higher than those of non-VAP group, the differences were statistically significant （ P〈0.05 ） . The peptide, lactic acid, D-dimer and APACHEⅡ score of the death group were higher than those in survival group, the differences were statistically significant （P〈0.05） .The copeptin, lactic acid and D-dimer all have good sensitivity and specificity.Conclusion： Copeptin, lactic acid and D-dimer have a good role in suggesting on the ventilator-associated pneumonia and its prognosis, which has important clinical values.
出处
《中国医学创新》
CAS
2017年第15期41-44,共4页
Medical Innovation of China
基金
盐田区软科学研究及社会公益性项目(20150103)
