The sensitivity and specificity of combination with clinical pulmonary infection score (CPIS), C-reactive protein (CRP) and neutrophile granulocyte(NEU) to predict ventilator associated pneumonia
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摘要:
目的评价联合临床肺部感染评分(CPIS)、C反应蛋白(CRP)、中性粒细胞(NEU)3者在预测呼吸机相关性肺炎(VAP)的敏感度与特异度。 方法以29例VAP患者作为观察组,以未发生VAP的机械通气患者作为对照组,采用受试者工作特征曲线(ROC)评价CPIS、CRP 及NEU预测VAP 的敏感度与特异度。 结果VAP 组患者CPIS、CRP 及NEU均显著高于对照组(P=0.023、0.039及0.031)。CPIS对应的曲线下面积(AUC)为0.669,95% 可信区间(CI)为(0.507,0.830);CRP对应的AUC为0.643,95% CI为(0.487,0.798);NEU对应的AUC为0.661,95% CI为(0.507,0.815)。CPIS与NEU两者均与VAP存在显著相关性(P=0.034、0.043),而CRP与VAP无存在显著性差异(P=0.074)。当CPIS取值为7分时,其预测VAP的敏感度(阳性率)为89.66%,特异度为93.26%;当CRP取值为14 mg/L时,其预测VAP的敏感度为79.31%,特异度为87.74%;当NEU取值为83%时,其预测VAP的敏感度为96.55%,特异度为91.45%。 结论综合CPIS>7分、CRP>14 mg/L及NEU>83%,可显著提高预测VAP的敏感度及特异度。 -
关键词:
- 呼吸机相关性肺炎 /
- 临床肺部感染评分 /
- 受试者工作特征曲线;敏感度 /
- 特异度 /
Abstract:Objective To observe the sensitivity and specificity of combination with clinical pulmonary infection score (CPIS), C-reactive protein (CRP) and neutrophile granulocyte(NEU) to predict ventilator associated pneumonia. Methods 29 patients with VAP were as observation group, with VAP in mechanical ventilation patients as control group, using the receiveroperating characteristic curve (ROC) evaluation CPIS, CRP and NEU predict the sensitivity of the VAP and specific degrees. Results The group of patients with VAP CPIS, CRP and NEU were significantly higher than the control group (P=0.023, 0.039 and 0.023). CPIS corresponds to the area under the curve (AUC) was 0.669, 95% confidence interval (CI) to (0.507, 0.507); CRP corresponding AUC 0.643, 95% CI (0.487, 0.487); NEU corresponding AUC 0.661, 95% CI (0.507, 0.507). CPIS with NEU both with VAP exist significant correlation (P=0.034, 0.043), but the CRP and VAP has no significant differences (P=0.074). When the CPIS values of 7 points, the predict the sensitivity of the VAP (positive) was 89.66%, 93.26%; When the CRP values for 14 mg/L, the prediction of VAP sensitivity was 79.31%, 87.74%; When the NEU values is 83%, and its prediction of VAP sensitivity was 96.55%, 91.45%. Conclusions Comprehensive CPIS >7 points, CRP >14 mg/L and NEU >83%, the forecasting can significantly increase the sensitivity of the VAP and specific degrees. -
表 1 两组患者CPIS、CRP及NEU数值比较(x±s)
分组 n CPIS CRP (mg/L) NEU (%) VAP组 29 4.38 34.28 81.17 对照组 37 5.48 31.62 72.79 t 3.261 8.647 12.923 P 0.023 0.039 0.031 表 2 各指标对应的阳性与阴性数量比较(n=29)
指标 VAP (+) non-VAP (-) 合计 CPIS (>7) 26 3 29 CRP (>14 mg/L) 23 6 29 NEU (>83%) 25 4 29 CPIS+CRP+NEU 28 1 29 合计 102 14 116 -
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