乳酸脱氢酶在成人社区获得性肺炎严重程度诊断中的价值

摘要

目的 探讨乳酸脱氢酶(LDH)水平在社区获得性肺炎(CAP)患者的变化及其对肺炎严重程度的诊断价值. 方法 搜集我院收治的社区获得性肺炎患者,共120例.提取患者的性别、年龄、氧合指数、PSI评分及入院时的检验结果,包括血常规、血气分析、门冬氨酸转移酶(AST)、谷丙氨酸转移酶(ALT)、LDH等资料.根据病情严重程度,将患者分为普通肺炎组和重症肺炎组,比较两组患者之间各项指标的差异,使用回归分析、ROC曲线及logistic回归分析LDH与氧合指数及病情严重性之间的关系及LDH诊断重症肺炎的最佳截断值. 结果 相较于普通肺炎组,重症肺炎组有更高的AST、LDH水平(P<0.05),血小板计数及氧合指数更低(P<0.05);logistic回归分析发现,LDH及AST与患者病情严重性相关;ROC分析显示,曲线下面积为0.89,95% CI(0.815,0.944),P=0.03,截点为651U/L,此截点处敏感度为79.5,特异性为89.2,Youden指数为0.69;LDH与氧合指数存在负相关(回归系数-0.041,P<0.05).结论 LDH与CAP严重程度相关,可以作为评估患者病情的重要指标之一.%Objective To investigate the changes of lactate dehydrogenase (LDH) level in patients with community acquired pneumonia (CAP) and its diagnostic value for the severity of pneumonia.Methods 120 CAP patients were collected.Their gender, age, blood gas analysis, live function, PSI score and routine blood test were recorded on the first day after admission.According to the severity of the disease, the patients were divided into the ordinary pneumonia group and the severe pneumonia group.Regression analysis, ROC curve and logistic regression analysis were used to analyze the relationship between LDH and oxygenation index, the relationship between LDH and severity of CAP, and the best cut-off value of LDH diagnosis of severe pneumonia.Results Compared with the ordinary pneumonia group, the severe pneumonia group had higher level of AST, LDH (P<0.05), and lower platelet count and oxygenation index (P<0.05).Logistic regression analysis showed that LDH and AST were correlated with the severity of the disease.ROC analysis showed that the area under the curve was 0.89 (95% CI (0.815, 0.944), P=0.03), the cut-off point was 651U/L, the sensitivity was 79.5, the specificity was 89.2, and the Youden index was 0.69.There was a negative correlation between LDH and oxygenation index (regression coefficient-0.041, P<0.05).Conclusion LDH is related to the severity of CAP, and it can be used as one of the important indicators to assess the severity of the patient's condition.