| 刘可娜,王洪阁,毛真真,于得海,高洪雪.血清PCT、presepsin和Gas6对老年慢性心力衰竭合并肺部感染患者病情及预后的评估价值[J].,2023,(15):2924-2929 |
| 血清PCT、presepsin和Gas6对老年慢性心力衰竭合并肺部感染患者病情及预后的评估价值 |
| The Value of Serum PCT, Presepsin and Gas6 in Evaluating the Condition and Prognosis of Senile Patients with Heart Failure Complicated with Pulmonary Infection |
| 投稿时间：2023-03-30 修订日期：2023-04-24 |
| DOI：10.13241/j.cnki.pmb.2023.15.024 |
| 中文关键词: 老年 心力衰竭 肺部感染 PCT presepsin Gas6 病情 预后 |
| 英文关键词: Senile Heart failure Pulmonary infection PCT Presepsin Gas6 Condition Prognosis |
| 基金项目:山东省中医药科技发展计划项目（2019-0919） |
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| 中文摘要: |
| 摘要 目的：探讨血清降钙素原（PCT）、白细胞分化抗原14亚型（presepsin）联合生长停滞特异性基因产物6（Gas6）对老年慢性心力衰竭（CHF）患者合并肺部感染患者病情及预后的评估价值。方法：412例老年CHF患者根据有无合并肺部感染分为肺部感染组（n=176）和无肺部感染组（n=236），另选取同期体检健康的40例健康体检者作为健康对照组，比较三组血清PCT、presepsin、Gas6水平。统计住院28 d内老年CHF合并肺部感染患者的预后情况，根据预后不同分为死亡组（n=37）和生存组（n=139），多因素Logistic回归模型分析老年CHF合并肺部感染患者死亡的危险因素。采用受试者工作特征（ROC）曲线分析血清PCT、presepsin联合Gas6对老年CHF合并肺部感染患者死亡的预测价值。结果：肺部感染组和无肺部感染组血清PCT、presepsin、Gas6水平均高于健康对照组，且肺部感染组高于无肺部感染组（P＜0.05）。多因素Logistic回归分析显示，年龄偏高、心功能分级Ⅳ级、PCT升高、presepsin升高、Gas6升高均是导致老年CHF合并肺部感染患者死亡的独立危险因素（P＜0.05）。ROC结果显示，血清PCT、presepsin、Gas6单独及联合检测对预测老年CHF合并肺部感染患者死亡风险的AUC分别为0.663、0.731、0.751、0.855，三指标联合检测的预测效能优于各指标单独检测。结论：血清PCT、presepsin及Gas6水平在老年CHF合并肺部感染患者中升高，且是短期预后不良的独立危险因素，检测PCT、presepsin及Gas6水平对老年CHF合并肺部感染患者病情及预后具有一定评估价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the value of serum procalcitonin (PCT), leukocyte differentiation antigen 14 subtype (presepsin) and growth arrest specific gene product 6 (Gas6) in evaluating the condition and prognosis of senile patients with chronic heart failure(CHF) complicated with pulmonary infection. Methods: 412 senile patients with CHF who were divided into pulmonary infection group (n=176) and non-pulmonary infection group (n=236) according to whether they were complicated with pulmonary infection. Another 40 healthy patients during the same period were selected as healthy control group. The serum PCT, presepsin and Gas6 levels of the three groups were compared. The prognosis of senile patients with CHF complicated with pulmonary infection within 28d of hospitalization was counted, and they were divided into death group (n=37) and survival group (n=139) according to different prognosis. Multivariate Logistic regression models were used to analyze the risk factors of death in senile patients with CHF complicated with pulmonary infection. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum PCT, presepsin combined with Gas6 for mortality in senile patients with CHF complicated with pulmonary infection. Results: The serum PCT, presepsin and Gas6 levels in the pulmonary infection group and the non-pulmonary infection group were higher than those in the healthy control group, and the pulmonary infection group was higher than the non-pulmonary infection group (P<0.05). Multivariate Logistic regression analysis showed that higher age, cardiac function grade Ⅳ, elevated PCT, elevated presepsin and elevated Gas6 were independent risk factors for death of senile patients with CHF complicated with pulmonary infection (P<0.05). The ROC results showed that the AUC of serum PCT, presepsin, and Gas6 alone and in combination to predict the risk of death in senile patients with CHF complicated with pulmonary infection were 0.663, 0.731 , 0.751 and 0.855, respectively. The predictive efficacy of the combined detection of three indicators was better than that of individual detection of each indicator. Conclusion: Serum PCT, presepsin and Gas6 levels increased in senile patients with CHF complicated with pulmonary infection, and are independent risk factors for poor short-term prognosis. Detecting the levels of PCT, presepsin, and Gas6 has certain evaluation value for the condition and prognosis of senile patients with CHF complicated with pulmonary infection. |
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