中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (9): 848–851.doi: 10.12007/j.issn.0258-4646.2016.09.018

• 论著 • 上一篇    下一篇

凝血/纤溶指标评估急诊社区获得性肺炎病情的研究

段蒙新,赵洋子,崇巍   

  1. 中国医科大学附属第一医院急诊科,沈阳 110001
  • 收稿日期:2015-06-18 出版日期:2016-09-28 发布日期:2016-08-29
  • 通讯作者: 崇巍 E-mail:chongweixiena@126.com
  • 作者简介:段蒙新(1987 -),男,硕士研究生 .

Assessing of Coagulation/fibrinolysis Index for Severity of Community-acquired Pneumonia

DUAN Mengxin,ZHAO Yangzi,CHONG Wei   

  1. Department of Emergency,The First Hospital,China Medical University,Shenyang 110001 China
  • Received:2015-06-18 Online:2016-09-28 Published:2016-08-29

摘要: 目的 研究凝血/纤溶指标和急诊社区获得性肺炎(CAP)病情严重程度的关系。方法 回顾研究 2010 年 8 月至 2013 年8 月我院急诊科 96 例 CAP 患者的临床资料。计算急诊脓毒症相关病死率(MEDS)评分,根据 MEDS 评分将患者分为中/高死亡风险组和低死亡风险组。分析患者年龄、性别及急诊首次静脉血白细胞(WBC)计数、血小板(PLT)计数、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)、D-二聚体(D-D)、谷丙转氨酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)、尿素氮(BUN)、肌酐(CR)、脑钠肽(BNP)、血糖(GPT)与 MEDS 评分的关系。结果 将单因素分析中 P < 0.1 的指标(PT、APTT、INR、D-D)纳入 logistic 多因素回归分析,年龄(β =0.077,OR =1.080,P = 0.005)、PLT(β =-0.011,OR =0.989,P =0.010)、BUN(β =0.213,OR =0.808,P = 0.016)、D-D(β =0.190,OR =1.209,P = 0.044)、INR(β =4.758,OR =116.469,P =0.042)为MEDS 评分中/高死亡风险组的独立危险因素。将独立危险因素绘制受试者工作曲线(ROC),D-D、INR 、年龄、BUN 、PLT ROC曲线下面积分别为 0.686、0.619、0.611、0.602、0.283。 结论 凝血/纤溶指标中除了 D-D 之外,INR 也可以辅助评估急诊 CAP 病情严重程度。

关键词: 社区获得性肺炎, 急诊脓毒症相关病死率, D-二聚体, 国际标准化值

Abstract: Objective To investigate the relationship between the severity of patients with community-acquired pneumonia (CAP) in emergency department (ED) and coagulation/fibrinolysis index. Methods A total of 96 patients with CAP admitted in ED of the First Hospital of China Medical University from August 2010 to August 2013 were enrolled for the study and analyzed retrospectively. According to mortality in emergency department sepsis (MEDS) score, the patients were divided into high-moderate risk death group and low risk death group. In single-factor analysis, P < 0.1 was considered to be significant difference. These significances were analyzed with multiple-factor analysis,and P < 0.05 was considered to have significant difference. Receiver-operating characteristic(ROC)curves was drawn,and ROC areas under the curve(AUC),cut-off value,sensitivity, and specificity were calculated. Results The P < 0.1 factors were analyzed with logistic regression analysis,and the Results were as follow: age (β =0.077,OR =1.080,P = 0.005),PLT (β =-0.011,OR =0.989,P = 0.010),BUN(β =0.213,OR =0.808,P = 0.016),D-D (β =0.190,OR =1.209,P = 0.044),INR (β =4.758,OR =116.469,P = 0.042)were considered the independent risk factors in high-moderate risk death group. AUCs ranked in descending order were those of BUN, age, INR and D-D. Conclusion Coagulation/fibrinolysis index, such as D-D and INR, can be indicators for assessing the degree of severity of patients with CAP in ED.

Key words: community-acquired pneumonia, mortality in emergency department sepsis, D-dimer, international normalized ratio

中图分类号: 

  • R563.1
[1] 芦婷婷, 王治博. 术前血浆纤维蛋白原和D-二聚体水平与结直肠癌预后的关系[J]. 中国医科大学学报, 2018, 47(6): 513-518.
[2] 裴培,刘志. 急诊社区获得性肺炎患者中类肺炎性胸腔积液的危险因素分析[J]. 中国医科大学学报, 2017, 46(7): 653-655.
[3] 赵洋子 ,苏广胜 ,李卉 ,吴曦子 ,曾仁庆 ,李蕙伊 ,刘畅 ,赵丽 ,徐俊杰 ,崇巍. 疑诊肺栓塞患者患病风险评估的新模型[J]. 中国医科大学学报, 2017, 46(3): 266-269.
[4] 温宇,张海英,崇巍. MEDS和CURB65评分对社区获得性肺炎病情的评估[J]. 中国医科大学学报, 2012, 41(12): 1138-1140.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!

中国医科大学学报版权所有©2018

未经允许,严禁擅自转载本站图文资料

地址:中国 沈阳市沈北新区蒲河路77号 110122

辽ICP备05014850

JOURNAL OF CHINA MEDICAL UNIVERSITY

ADDRESS: NO.77 PUHE ROAD

SHENYANG NORTH NEW AREA, SHENYANG

LIAONING PROVINCE, P.R. CHINA