胡莎莎 常晓青 李丹丹 李英*

作者单位：450003 河南省郑州市，河南大学人民医院呼吸与危重症医学科* 通讯作者

基金项目：河南省医学科技攻关计划省部共建项目（编号：SB201901078）

【摘要】 目的 探索C 反应蛋白与白蛋白比值（CRP/ALB）、降钙素原（PCT）与扩展英国胸科协会改良肺炎（CURB-65）评分对老年重症肺炎的预测价值。方法 收集2020 年1 月- 2021 年12 月在河南省人民医院呼吸与危重症医学科就诊的老年社区获得性肺炎104 例，根据中国成人社区获得性肺炎诊断和治疗指南（2016 版）将患者分为重症组（47 例）与普通组（57 例），分析CRP/ALB、PCT 与扩展CURB-65 评分对老年重症肺炎的预测价值。结果 经过单因素及多因素Logistic 回归分析，CRP/ALB、PCT、扩展CURB-65 评分与老年重症肺炎密切相关（P <0.05），是老年重症肺炎的危险因素。ROC 曲线分析结果显示，三项指标均具有预测老年重症肺炎的作用，但三者并联试验，预测效果有所提升。三项指标联合对老年重症肺炎的预测结果与实际结果高度一致（Kappa =0.79），并且预测的漏诊率和误诊率极低（灵敏度=97.9%，特异度=82.5%），提示三项指标联合试验具有较高的临床应用价值。结论 CRP/ALB、PCT 联合扩展CURB-65 评分对老年重症肺炎的预测结果与实际结果高度一致，漏测率极低。

【关键词】 C 反应蛋白与白蛋白比值；降钙素原；扩展英国胸科协会改良肺炎评分；老年重症肺炎

中图分类号 R563.1 文献标识码 A 文章编号 1671-0223(2023)06-413-05

Predictive value of CRP/ALB, PCT and expanded CURB-65 score in elderly patients with severe pneumonia Hu Shasha, Chang Xiaoqing, Li Dandan, Li Ying. Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Henan University, Zhengzhou 450003, China

【Abstract】 Objective To explore the predictive value of C-reactive protein to albumin ratio (CRP/ALB), procalcitonin (PCT) and the expanded CURB-65 score for severe pneumonia in the elderly. Methods Totally 104 elderly patients with community-acquired pneumonia who visited the Department of Respiratory and Critical Care Medicine of Henan Provincial People's Hospital from January 2020 to December 2021 were collected. According to the Chinese Guidelines for the Diagnosis and Treatment of Adult Community acquired Pneumonia (2016 Edition), the patients were divided into the severe group (47 cases) and the general group (57 cases). The predictive value of CRP/ALB, PCT and expanded CURB-65 for elderly patients with severe pneumonia was analyzed. Results Through univariate and multivariate Logistic regression analysis, CRP/ALB, PCT and expanded CURB-65 scores were closely related to severe pneumonia in the elderly (P <0.05), and were risk factors for severe pneumonia in the elderly. The ROC curve analysis results showed that the three indicators had the function of predicting severe pneumonia in the elderly, but the prediction effect had been improved when the three indicators are tested in parallel. The predicted results of the combination of the three indicators

for severe pneumonia in the elderly were highly consistent with the actual results (Kappa =0.79), and the predicted missed diagnosis rate and misdiagnosis rate are extremely low (sensitivity =97.9%, sensitivity =82.5%), suggesting that the combination of the three indicators has high clinical application value. Conclusion The predicted results of CRP/ALB, PCT combined with expanded CURB-65 score for severe pneumonia in the elderly are highly consistent with the actual results, and the missed test rate is very low.

【Key words】 C-reactive protein to albumin ratio; Procalcitonin; Expanded CURB-65; Severe pneumonia in the elderly