重症社区获得性肺炎患者PIV、IL-6、HBP、PAB水平对 疗效的评估价值.

Objective To analyze levels of pan-immune-inflammation value (PIV), interleukin-6 (IL-6), heparin-binding protein (HBP) and prealbumin (PAB) in patients with severe community-acquired pneumonia (CAP), and their values in evaluating the therapeutic effect at 72 h after admission. Methods According to the initial (72 h) treatment outcome, 120 patients with severe CAP (the severe group) were divided into the effective group (n=87) and the failed group (n=33). Meanwhile, 120 patients with non-severe CAP admitted in the same period were selected as the non-severe group. PIV, IL-6, HBP and PAB levels on the day after admission were compared between the severe group, the non-severe group, the failed group and the effective group. The value of above indicators in evaluating the condition of CAP and the therapeutic effect at 72 h after admission separately and in combination were analyzed using receiver operating characteristic (ROC) curves. Results Compared with the non-severe group, there were higher PIV, IL-6 and HBP levels, and lower PAB levels in the servere grouop (P < 0.05). ROC curves indicated that for evaluating severe CAP using a single indicator, the area under the curve (AUC) of PIV was the highest [0.830 (95%CI: 0.780-0.881)]. The AUC of PIV combined with IL-6, HBP and PAB for evaluating severe CAP was 0.929 (95%CI: 0.892-0.967), which was higher than that of evaluation using a single indicator (P < 0.05). Compared with the effective group, there were higher PIV, IL-6 and HBP levels, and lower PAB level in the failed group (P < 0.05). ROC curves indicated that for evaluating the therapeutic effect on severe CAP at 72 h after admission using a single indicator the AUC of PIV was the highest [0.777 (95%CI: 0.692-0.862)]. The AUC of PIV combined with IL-6, HBP and PAB for evaluating the therapeutic effect on severe CAP at 72 h after admission was 0.916 (95%CI: 0.846-0.986), which was higher than that of evaluation using a single indicator (P < 0.05). Conclusion Detection of PIV combined with IL-6, HBP and PAB has a good value in evaluating the condition of patients with CAP and the therapeutic effect on severe CAP at 72 h after admission. [ABSTRACT FROM AUTHOR]