肺部超声评分结合血清炎症标志物对重症肺炎的诊断及预后评价

Bo Fu, Peng Zhang, JunHua Zhang
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摘要

目的:分析肺超声评分(LUS)联合血清炎症指标在不同严重程度重症肺炎中的意义及其对预后的临床价值。方法:选取2017年6月至2021年6月甘肃省立医院收治的100例重症肺炎患者作为研究对象。根据急性生理和慢性健康(APACHE II)评分分为低危组(28例)、中危组(39例)和高危组(33例)。收集患者一般临床资料(年龄、性别、吸烟史、基础疾病),测定患者肺超声评分(LUS),血清炎症指标(IL-6、IL-10、TNF-α、CRP、NLR)水平;pearson相关分析评价LUS评分、血清炎症指数水平与疾病严重程度的相关性;受试者工作特征(ROC)曲线分析,评价LUS评分与血清炎症指数联合诊断对重症肺炎严重程度的预后价值。 结果:随着重症肺炎严重程度的增加,LUS评分和体内炎症水平不断升高,LUS联合血清炎症指标可区分重症肺炎低危、中危、高危的严重程度,具有较高的诊断价值。此外,LUS与血清炎症标志物的联合诊断也与重症肺炎患者的预后密切相关,可区分预后。 结论:LUS联合血清炎症指标(IL-6、IL-10、TNF-α、CRP、NLR)可区分重症肺炎的严重程度及预后,可能是诊断重症肺炎并指导临床早期干预的新方向。
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Diagnosis and prognosis evaluation of severe pneumonia by lung ultrasound score combined with serum inflammatory markers
Objective: To analyze the significance of lung ultrasound score (LUS) combined with serum inflammatory indexes in different severities of severe pneumonia and and its clinical value on prognosis. Methods: A total of 100 patients with severe pneumonia who were treated in the Gansu Provincial Hospital from June 2017 to June 2021 were selected as the research objects. According to the acute physiology and chronic health (APACHE II) score, they were divided into low-risk group (28 cases) and medium-risk group (39 cases) and high-risk group (33 cases). The general clinical data of the patients (age, gender, smoking history, and underlying diseases) were collected, the lung ultrasound score (LUS) of the patients was measured, and the serum inflammatory indicators (IL-6, IL-10, TNF-α, CRP and NLR) levels; pearson correlation analysis to evaluate the correlation between LUS score, serum inflammatory index levels and disease severity; receiver operating characteristic (ROC) curve analysis to evaluate the prognostic value of the combined diagnosis of LUS score and serum inflammatory index for the severity of severe pneumonia. Results: With the increase of the severity of severe pneumonia, the LUS score and the level of inflammation in the body continued to increase, and LUS combined with serum inflammatory indexes could distinguish the severity of low-risk, medium-risk and high-risk of severe pneumonia, and had high diagnostic value. In addition, the combined diagnosis of LUS and serum inflammatory markers is also closely related to the prognosis of patients with severe pneumonia, which can distinguish the prognosis. Conclusion: LUS combined with serum inflammatory indicators (IL-6, IL-10, TNF-α, CRP and NLR) can differentiate the severity and prognosis of severe pneumonia, which may be a new direction for the diagnosis of severe pneumonia and guide early clinical intervention.
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来源期刊
CiteScore
4.20
自引率
6.20%
发文量
113
审稿时长
12 weeks
期刊介绍: Reciprocal interdependence between infectious and hematologic diseases (malignant and non-malignant) is well known. This relationship is particularly evident in Mediterranean countries. Parasitosis as Malaria, Leishmaniosis, B Hookworms, Teniasis, very common in the southeast Mediterranean area, infect about a billion people and manifest prevalently with anemia so that they are usually diagnosed mostly by experienced hematologist on blood or bone marrow smear. On the other hand, infections are also a significant problem in patients affected by hematological malignancies. The blood is the primary vector of HIV infection, which otherwise manifest with symptoms related to a reduction in T lymphocytes. In turn, infections can favor the insurgency of hematological malignancies. The causative relationship between Epstein-Barr virus infection, Helicobacter pylori, hepatitis C virus, HIV and lymphoproliferative diseases is well known.
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