重症肺炎患者血清磷水平与30d病死率的相关性研究

目的探讨重症肺炎患者血清磷水平与30d病死率的相关性。方法将2014年1月至2015年10月于该院呼吸科住院治疗的80例重症肺炎患者纳入本研究,根据30d死亡事件,分为死亡组(n=30)和存活组(n=50)。比较血清磷,急性生理学与慢性健康状况评价系统(APACHEⅡ)评分,肺部感染(CPIS)评分,英国胸科协会改良肺炎评分(CURB-65评分),感染相关器官衰竭评估(SOFA)评分以及肺炎严重指数(PSI)评分水平差异。结果死亡组患者血清磷水平低于存活组患者(P0.05)。ROC曲线分析提示血清磷、APACHEⅡ评分和CURB-65评分的预测30d死亡事件的AUC分别为0.732、0.664和0.682。相关性分析提示血清磷水平与30d死亡事件呈负相关(r=-0.566,P0.05)、CURB-65评分(r=-0.392,P0.05)和PSI评分(r=-0.235,P0.05)呈负相关。Logistics回归分析提示血清磷小于0.030 mmol/L(OR=1.56)和CURB-65评分大于3.9(OR=1.15)为MACE发生的独立危险因素。结论重症肺炎患者入院时血清磷水平与30d病死率密切相关。

Study on correlation between serum phosphorus level and 30-day mortality rate in patients with severe pneumonia

Objective To investigate the correlation between serum phosphorus level and 30‐day mortality rate in the patients with severe pneumonia(SP) .Methods Consecutive 80 SP patients in the respiration department our hospital from January 2014 to October 2015 were enrolled in this study and divided into the survival group(n= 50) and death group(n= 30) based on the 30‐day death events .The serum phosphorus level ,APACHE II score ,CPIS score ,CURB‐65 score ,SOFA score and PSI score were com‐pared between the two groups .Results The phosphorus level in the death group was significantly lower than that in the survival group(0 .37 ± 0 .06) mmol/L vs .(0 .61 ± 0 .05) mmol/L ,P < 0 .05] .The ROC curve analysis showed that the AUC of serum phosphorus ,APACHE II score and CURB‐65 score for predicting 30‐day death events was 0 .732 ,0 .664 and 0 .682 respectively . The correlation analysis showed that serum phosphorus level was negatively correlated with 30‐day death events(r= - 0 .566 ,P<0 .05) ,CURB‐65 score(r= - 0 .392 ,P < 0 .05) and PSI score .(r = - 0 .235 ,P < 0 .05) .The Logistic regression analysis showed that serum phosphorus(< 0 .030 mmol/L ,OR = 1 .56) and CURB‐65 score(> 3 .9 ,OR = 1 .15) were the independent risk factors of major adverse cardiovascular event (MACE) occurrence .Conclusion The serum phosphorus level at admission is closely related with 30‐day mortality rate in SP patients .