联合检测乳酸和脑钠肽对老年性肺炎严重程度及预后评估的价值

摘要

目的 探讨联合检测乳酸(lactate)和脑钠肽(BNP)对老年性肺炎严重程度及预后的预测价值.方法 选择2015年1月至2016年12月在我院住院的60例老年性肺炎患者,对其进行肺炎严重指数(PSI)评分,同时检测血lactate和BNP.比较PSI不同组之间lactate和BNP的水平变化,以及死亡组和存活组之间lactate和BNP差异,同时比较联合检测lactate和BNP与单独检测lactate或BNP对老年性肺炎严重程度及预后评估的价值.结果 PSI分级Ⅰ～Ⅱ、Ⅲ、Ⅳ、Ⅴ各组各包括29、13、11、7例患者,四组之间年龄及体质量差异均无统计学意义.除Ⅰ～Ⅱ组和Ⅲ组之间lactate和BNP水平无明显差异外,四组患者之间lactate和BNP均有明显差异,具有统计学意义(P＜0.05),且研究数据提示lactate和BNP水平越高,肺炎越严重;存活组lactate和BNP分别为2.03 ±0.27mmol/L和130.52 ±29.95pg/mL,而死亡组lactate和BNP较存活组明显升高,分别为5.39±0.58mmol/L及459.84±37.59pg/mL,两组差异具有统计学意义(P＜0.05);联合检测lactate和BNP双阳性组中重症肺炎比例和病死率分别为87.6％和41.2％,而lactate或BNP单阳性组中重症肺炎比例和病死率为60.9％和26.1％.双阳性组中重症肺炎比例及病死率均明显高于单阳性组.结论 lactate和BNP检测对于老年性肺炎严重程度及预后评估具有一定的价值,而联合检测lactate和BNP较单独检测lactate和BNP意义更大.%Objective To evaluate the predictive values of combined measurement of lactate and BNP in elder pneumonia.Methods The levels of lactate and BNP in 60 senior patients with pneumonia were measured and pneumonia severity index (PSI) was evaluated.According to PSI score,cases were divided into different groups.After treatments,cases were also divided into survival group or death group.The levels of lactate and BNP in different groups were compared to evaluate their relationship with severity and prognosis of older pneumonia.Results The levels of lactate and BNP were significantly increased with the severity of pneumonia in senior patients.The levels of lactate and BNP in death group were markedly higher than survival group.The combination of lactate and BNP showed more effective in the prediction of severity and prognosis of pneumoniain senior patients.Conclusion The detection of lactate and BNP could help to evaluate the severity and prognosis of pneumoniain senior patients,and the combined measurement of lactate and BNP showed higher accuracy.