Objective To evaluate the short-term prognostic value of serum CRP and APACHEⅡ in adult patients with community-acquired pneumonia (CAP). Methods APACHEⅡ and serum CRP levels in 125 adult patients with CAP from January 2015 to December 2016 were analyzed retrospectively. The patients were divided into the survival group and the death group. Additionally, PSI score and CURB-65 score were used to classify CAP pa-tients into the three groups according to the severity of disease, and for predicting mortality. Results The APACHEⅡand the level of CRP were significantly high in dead patients than in survival patients ( P<0. 001 ) . APACHEⅡand CRP levels increased with the aggravation of the disease severity as assessed by PSI and CURB-65 score ( A-PACHEⅡ, P<0. 001 and CRP, P=0. 001). In addition, there were positive correlations between APACHEⅡand PSI (rs =0. 885, P<0. 001), APACHEⅡ and CURB-65 (rs =0. 835, P<0. 001), CRP and PSI (rs =0. 358, P<0. 001), and CRP and CURB-65 (rs =0. 345, P <0. 001) respectively. The receiver operating characteristic curve analysis showed the area under the curve ( AUC) of APACHEⅡ, PSI and CURB-65 in the prediction of 30-day mortality were larger than CRP (all P<0. 05), and the AUC of APACHEⅡwas larger than CURB-65 (P<0. 05). Conclusion APACHEⅡand serum CRP are positively correlated with the disease severity and mortality of the adult patients with CAP, and it can be used to predict short-term mortality of CAP efficiently.%目的 探讨APACHEⅡ评分和血清CRP在成人社区获得性肺炎(CAP)患者近期预后评估中的价值.方法 回顾性分析淮南市第一人民医院呼吸内科和ICU 2015年1月至2016年12月收治的125例成人CAP患者的APACHEⅡ评分和血清CRP,根据30天生存情况和PSI评分、CURB-65评分将CAP患者分为生存组、死亡组、低风险组、中风险组和高风险组,观察其在不同预后组和风险组间的差异.结果 死亡组CAP患者APACHEⅡ评分、CRP均高于存活组(P<0.001).APACHEⅡ评分和CRP在不同风险组间比较,差异有统计学意义(APACHEⅡ评分,P<0.001;CRP,P=0.001),两者均随风险增加而增加.APACHEⅡ评分、CRP与PSI评分、CURB-65评分间存在正相关性(rs分别为0.885、0.835、0.358、0.345,P<0.001).使用ROC曲线分析APACHEⅡ评分、PSI评分和CURB-65评分预测CAP患者30天病死率的曲线下面积(AUC)均大于CRP,APACHEⅡ评分的AUC大于CURB-65评分(P<0.05).结论 APACHEⅡ评分和血清CRP与成人CAP患者病情严重程度和近期病死率呈正相关,使用APACHEⅡ评分和血清CRP检测对成人CAP患者近期预后评估具有重要的临床价值和指导意义.
展开▼
