摘要
目的 研究呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)患者出院后生存质量情况,并对特征变量进行相关性分析.方法 选取2019年11月至2022年11月诊治的100例VAP作为研究对象,收集患者临床特征、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分;分析患者生存质量现状,比较不同临床、肺功能特征患者生存质量;分析降钙素原(PCT)、白细胞计数(WBC)、C反应蛋白(CRP)与肺功能指标、WHOQOL-BREF评分的相关性;采用多元线性回归分析VAP患者生存质量的影响因素;采用受试者工作特征(ROC)曲线分析PCT、WBC、CRP联合预测患者生存质量的价值.结果 100例VAP患者WHOQOL-BREF量表生理、心理、社会关系维度评分及总评分均低于常模评分(P＜0.01),且低生存质量患者39例,占比为39.00%;年龄大、心功能不全及PCT、WBC、CRP升高人群低生存质量者占比比较差异有统计学意义(P＜0.01);用力肺活量(FVC)异常人群低生存质量患者占比高于正常人群(P＜0.01);第1秒用力呼气量(FEV1)/FVC异常人群低生存质量患者占比高于正常人群(P＜0.01);VAP患者PCT、WBC、CRP与FVC、FEV1/FVC、WHOQOL-BREF评分呈负相关(P均＜0.05);多元线性回归分析显示,年龄大、心功能不全及PCT、WBC、CRP升高是VAP患者生存质量的影响因素(P＜0.01);ROC曲线显示,PCT、WBC联合CRP预测VAP患者生存质量的曲线下面积(AUC)为0.911,大于PCT、WBC、CRP单一预测的AUC(P＜0.01).结果 VAP患者出院后低生存质量者占比较高,年龄大、心功能不全及PCT、WBC、CRP升高是VAP患者生存质量的影响因素;且PCT、WBC、CRP异常水平与肺功能、生存质量呈负相关,其联合预测患者生存质量具有一定参考价值.
Abstract
Objective To investigate the quality of life of patients with ventilator-associated pneumonia(VAP)after discharge,and to analyze its correlation with characteristic variables.Methods In total,100 patients with VAP diagnosed and treated from November 2019 to November 2022 were selected as the research subjects,and the clinical characteristics and the World Health Organization Quality of Life-BREF(WHOQOL-BREF)score of the patients were collected.The quality of life of patients was analyzed,and the quality of life of patients with different clinical and pulmonary function characteristics was compared.The correlations of procalcitonin(PCT),white blood cell count(WBC)and C reactive protein(CRP)with lung function index and WHOQOL-BREF score were analyzed.The factors influencing the quality of life of VAP patients were ana-lyzed by multiple linear regression.Receiver operating characteristic(ROC)curve was used to analyze the value of PCT,WBC and CRP in predicting patients'quality of life.Results The physiological,psychological,and social relationship dimension scores and total scores of 100 VAP patients on the WHOQOL-BREF scale were lower than the norm scores(P<0.01),and 39 patients had low quality of life(39.00%).There were significant differences in the proportion of low quality of life among indi-viduals of different ages,cardiac insufficiency,and elevation of PCT,WBC,and CRP(P<0.01).The proportion of patients with low quality of life in population with abnormal forced vital capacity(FVC)was higher than that in normal population(P<0.01),and the proportion of patients with abnormal forced expiratory volume in the first second(FEV1)/FVC was higher than that in normal population(P<0.01).In VAP patients,PCT,WBC and CRP were negatively correlated with FVC,FEV1/FVC and WHOQOL-BREF scores(all P<0.05).Multiple linear regression analysis showed that age,cardiac insufficiency,PCT,WBC and CRP were the influencing factors of long-term quality of life in VAP patients(P<0.01).ROC curve showed that the area under the curve(AUC)of PCT and WBC combined with CRP in predicting the quality of life of VAP patients was 0.911,which was larger than that predicted by PCT,WBC and CRP alone(P<0.01).Conclusion Low quality of life was more common in VAP patients after discharge.Age,cardiac insufficiency,and increased PCT,WBC and CRP were all factors af-fecting the qualityoflife of VAP patients.Abnormal expressions of PCT,WBC and CRP were negatively correlated with lung function and quality of life,and their combined detection had certain reference value for prediction of patients'quality of life.
基金项目
安徽省重点研究与开发计划项目(YDZX20183400004456)
国家科技期刊平台
NSTL
万方数据