老年社区获得性肺炎患者血磷水平与病情及预后的关系

摘要

Objective :To discuss the relationship of phosphate level with disease severity and recent prog‐nosis in elderly CAP patients .Methods :122 cases of elderly CAP patients were divided into critical group and non‐critical group ;death group and survival group according to disease severity and recent prognosis .Serum phosphor‐us ,blood routine ,blood gas analysis indicators were compared among these groups .Results :Compared with non‐critical group ,serum phosphorus ,sodium ,PaO2 of critical group were lower ,CRP increased (P < 0 .05) ;serum phosphorus of critical group were lower than non‐critical group (P< 0 .05) ;Pearson correlation analysis showed that serum phosphorus level was positively correlated with PaO2 ,and were negatively correlated with WBC and CRP ;Logistic regression analysis showed that low serum phosphorus level was high risk factor for recent death ;ROC curve analysis showed that ROCAUC of serum phosphoru predicting death was 0 .831 (95% CI = 0 .536 ~ 0 .927 , P<0 .05) ,the best diagnostic cut‐off value was 0 .67mmol/L ,sensitivity and specificity were 81 .7% and 76 .3% re‐spectively .Conclusion :Serum phosphorus level is closely related to disease severity and prognosis of elderly patients with CAP ,low phosphorus level may be an independent risk factors for death of patients with CAP .%目的：探讨老年社区获得性肺炎（CAP）患者血磷水平与病情及预后的关系。方法：将122例老年 CAP 患者依据患者病情严重程度及近期预后分为重症组和非重症组；死亡组和存活组；比较各组患者的血磷水平、血常规及血气分析等相关指标。结果：与非重症组比较，重症组患者血磷、血钠、氧分压（PaO2）较低（P＜0．05），CRP 显著增高（P＜0．05）；死亡组血磷水平亦低于生存组（P＜0．05）；Pearson 相关分析显示血磷水平与 PaO2呈正相关，而与 WBC 、CR P 呈负相关；Lo‐gistic 回归分析显示低血磷水平是患者近期死亡的高危因素；ROC 曲线分析显示血磷水平对老年CAP 患者近期死亡的 ROCAUC为0．831（95％ CI ＝0．536～0．927，P ＜0．05），最佳的诊断截点值为0．67mmol／L ，敏感性和特异性分别为81．7％和76．3％。结论：血磷水平与老年 CAP 患者病情严重程度及近期预后密切相关，低血磷水平可能是 CAP 患者近期死亡的独立危险因素。