| 李 玲,梁樱凡,秦 克,钟培英,廖山营.重症肺炎患者病原菌分布、临床结局分析及血清尿素氮与肌酐比值、尿素氮与白蛋白比值联合检测的临床意义[J].,2023,(12):2337-2342 |
| 重症肺炎患者病原菌分布、临床结局分析及血清尿素氮与肌酐比值、尿素氮与白蛋白比值联合检测的临床意义 |
| Analysis of Pathogenic Bacteria Distribution and Clinical Outcome in Patients with Severe Pneumonia and Clinical Significance of Combined Detection of Serum Urea Nitrogen to Creatinine Ratio and Urea Nitrogen to Albumin Ratio |
| 投稿时间：2023-03-03 修订日期：2023-03-26 |
| DOI：10.13241/j.cnki.pmb.2023.12.025 |
| 中文关键词: 重症肺炎 病原菌 尿素氮与肌酐比值 尿素氮与白蛋白比值 临床结局 |
| 英文关键词: Severe pneumonia Pathogenic bacteria Urea nitrogen to creatinine ratio Urea nitrogen to albumin ratio Clinical outcome |
| 基金项目:四川省科技计划项目（2019YJ0263） |
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| 中文摘要: |
| 摘要 目的：分析重症肺炎（SP）患者病原菌分布和临床结局并探讨血清尿素氮与肌酐比值（UCR）、尿素氮与白蛋白比值（UAR）联合检测的临床意义。方法：选取2019年8月～2022年8月三六三医院收治的107例SP患者，根据临床结局分为死亡组和存活组。分析SP患者病原菌分布情况。采用单因素和多因素Logistic回归分析SP患者临床结局的影响因素，采用受试者工作特征（ROC）曲线分析血清UCR、UAR水平对SP患者临床结局的评估价值。结果：107例SP患者痰液标本中培养出122株病原菌，其中革兰阴性菌75株（61.48%），革兰阳性菌39株（31.97%），真菌8株（6.56%）。107例SP患者院内死亡率为40.19%（43/107）。多因素Logistic回归分析显示，年龄增加、肺外并发症≥2个和UCR、UAR升高为SP患者临床结局不良的独立危险因素，氧合指数增加为其独立保护因素（P＜0.05）。ROC曲线分析显示，血清UCR、UAR联合评估SP患者临床结局的曲线下面积（AUC）大于各指标单独评估。结论：SP患者病原菌分布以革兰阴性菌为主，血清UCR、UAR升高为SP患者临床结局不良的独立危险因素，可能成为SP患者临床结局的辅助评估指标，且二者联合评估SP患者临床结局的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the pathogenic bacteria distribution and clinical outcome in patients with severe pneumonia (SP) and to explore the clinical significance of the combined detection of serum urea nitrogen to creatinine ratio (UCR) and urea nitrogen to albumin ratio (UAR). Methods: 107 patients with SP who were admitted to 363 Hospital from August 2019 to August 2022 were selected, and they were divided into death group and survival group according to clinical outcome. The pathogenic bacteria distribution in patients with SP were analyzed. Univariate and multivariate Logistic regression were used to analyze the influencing factors of clinical outcome of patients with SP, and receiver operating characteristic (ROC) curve was used to analyze the evaluation value of serum UCR and UAR levels on clinical outcome of patients with SP. Results: 122 strains of pathogenic bacteria were cultured in the sputum samples of 107 patients with SP，including 75 strains of gram-negative bacteria (61.48%), 39 strains of gram-positive bacteria (31.97%) and 8 strains of fungi (6.56%). The in-hospital mortality of 107 patients with SP was 40.19% (43/107). Multivariate Logistic regression analysis showed that increased age, extrapulmonary complications≥2 and elevated UCR and UAR were independent risk factors for poor clinical outcome of patients with SP, and increased oxygenation index was independent protective factor (P＜0.05). ROC curve analysis showed that, the area under the curve (AUC) of serum UCR and UAR combined assessment of clinical outcome of patients with SP was greater than that of each indicator separately. Conclusion: The pathogenic bacteria distribution in patients with SP is dominated by Gram-negative bacteria. The elevate of serum UCR and UAR are independent risk factors for the poor clinical outcome of patients with SP, which may become auxiliary evaluation indexes for the clinical outcome of patients with SP, and the combined evaluation of the two is of high value in the clinical outcome of patients with SP. |
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