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成人社区获得性肺炎严重程度与乳酸脱氢酶、血清淀粉样蛋白A相关性分析

Correlation analysis of adult community acquired pneumonia severity with lactate dehydrogenase and serum amyloid protein A

  • 摘要: 目的:分析成人社区获得性肺炎(community-acquired pneumonia, CAP)患者严重程度与乳酸脱氢酶(lactate dehydrogenase, LDH)、血清淀粉样蛋白A(serum amyloid protein A, SAA)的相关性。方法:选择2017年11月至2018年10月就诊于我院的CAP患者100例,记录患者性别、年龄、个人病史、体质指数(body mass index, BMI),测量血压、心率、每分钟呼吸次数,评估意识状态,完善胸部CT、血气分析,进行血常规、尿素氮、降钙素原(procalcitonin, PCT)、C反应蛋白(C reactive protein, CRP)、LDH、SAA检查。根据病情将患者分为普通肺炎组(n=62)、重症肺炎组(n=38),比较两组患者各项指标差异,分析各项指标与肺炎严重程度的关系。结果:普通肺炎组白细胞(WBC)、PCT、CRP、LDH、SAA水平低于重症肺炎组(P<0.05)。Logistic回归分析提示,LDH、SAA与患者病情严重程度相关(P<0.05);受试者工作特征(receiver operating characteristic, ROC)曲线分析提示LDH的曲线下面积(area under the curve, AUC)为0.894,截点为228.5 U/L,敏感度为81.6%,特异度为87.1%,Youden指数为0.687[95%置信区间(CI)0.819~0.969,P=0.000];SAA的AUC为0.802,截点为170 mg/L,敏感度为84.2%,特异度为85.5%,Youden指数为0.697(95%CI 0.714~0.889,P=0.000)。结论:LDH、SAA与CAP患者病情严重程度相关,可反映患者病情的严重性,有利于患者病情的评估。

     

    Abstract: Objective:To investigate the correlation of adult community-acquired pneumonia (CAP) severity with lactate dehydrogenase (LDH) and serum amyloid protein A (SAA). Methods:A total of 100 patients with CAP in our hospital from Nov. 2017 to Oct. 2018 were selected. Clinical characteristics including gender, age, personal medical history, body mass index (BMI) were recorded, blood pressure, heart rate, number of breaths per minute were measured, the state of consciousness, chest CT, blood gas analysis, routine blood test, urea nitrogen, procalcitonin (PCT), C reactive protein (CRP), LDH, SAA examinations were performed. According to their condition, the patients were divided into common pneumonia group (n=62) and severe pneumonia group (n=38). Differences in patients’ parameters between the two groups, and the relationship between various parameters and the severity of pneumonia was analyzed. Results:White blood cell (WBC), PCT, CRP, LDH, and SAA in common pneumonia group is lower than those in severe pneumonia group (P<0.05). Logistic regression analysis showed that LDH and SAA were correlated with the severity of the disease (P<0.05). Receiver-operating characteristic (ROC) analysis showed that area under the curve (AUC) of LDH was 0.894, the cut-off point was 228.5 U/L, with a sensitivity of 81.6%, and a specificity of 87.1%, the Youden index was 0.687 (95%CI 0.819-0.969, P=0.000). The AUC of SAA was 0.802, the cut-off point was 170 mg/L, with a sensitivity of 84.2%, and a specificity of 85.5%, the Youden index was 0.697 (95%CI 0.714-0.889, P=000). Conclusions:LDH and SAA might be related to the severity of CAP, and they have the potential to be used to reflect the severity of CAP.

     

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