摘要
目的探讨降钙素原（PCT）对老年急性左心衰竭合并社区获得性肺炎患者的病情评估、抗生素使用和预后的价值。方法对41例急性左心衰竭合并社区获得性肺炎患者（心衰肺炎组）和36例急性左心衰竭患者（心衰组）进行PCT、B型钠尿肽（BNF）及心脏彩超检查，比较两组患者的PCT动态变化、住院时间、病情加重情况，同时分析心衰肺炎组PCT与肺炎严重程度评分（CURB-65）、静脉抗生素使用时间、住院时间及病情加重情况的关系。结果心衰肺炎组与心衰组比较，PCT明显升高[（1．25±1．80）μg／L比（0．11±0．02）μg／L]、住院时间明显延长[（13．73±5．06）d比（11．61±3．07）d3（t=3．76、2．18，均P〈0．05）。心衰肺炎组PCT与CURB-65评分呈正相关（r=0．585，P〈0．05）。随着PCT水平的升高，心衰肺炎组患者静脉抗生素使用时间及住院时间明显延长（F=3．58、3．53，P=0．038、0．039），在PCT〉0．5μg／L组出现了5例患者病情加重。结论PCT与老年急性左心衰竭合并社区获得性肺炎患者病情严重程度密切相关，可作为评估老年患者急性左心衰竭是否合并社区获得性肺炎的一项指标指导抗生素使用，评估预后。
Objective To investigate the clinical value of procalcitonin in the assessment of disease state, antibiotic administration and prognosis in elderly patients with acute left heart failure and community-acquired pneumonia. Methods Elderly patients were divided into two groups, with 41 in the acute left heart failure and community-acquired pneumonia group（the HF＋ P group）and 36 in the acute left heart failure group（the HF group）. Data on PCT, BNP and cardiac Doppler ultrasonography were collected for all patients, and the two groups were compared for differences in dynamic changes of PCT,length of hospitalization and severity of illness. In addition, data from the HF＋ P group were analyzed for any potential association of PCT with CURB-65 scores, duration of antibiotic administration, length of hospitalization or severity of illness. Results Compared with the HF group,the HF＋ P group showed higher PCT and longer hospitalization. In the HF＋ P group, PCT levels were positively correlated with CURB-65 scores. As PCT levels increased, the duration of intravenous antibiotic administration and the length of hospitalization also increased. For those with PCT 〉0.5μg/L,5 patients exhibited aggravated severity of illness. Conclusions PCT is closely related to disease severity in elderly patients with acute left heart failure and community acquired pneumonia and can be used as a parameter for antibiotic administration and assessment of prognosis in this type of patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2016年第11期1183-1186,共4页
Chinese Journal of Geriatrics
关键词
左心衰竭
肺炎
降钙素
Heart failure
Pneumonia
Calcitonin
