血清D-二聚体、白蛋白及铁蛋白联合Fried衰弱量表对老年2型糖尿病并发肺部感染的预测价值
Value of serum D-dimer,albumin and ferritin combined with Fried scores in prediction of pulmonary infection in elderly patients with type 2 diabetes mellitus
戴靖榕 1李婕 2黄红 2何旭 2丁银菊 1李丽萍 1刘斌 1李燕2
作者信息
- 1. 中南大学湘雅医学院附属长沙医院/长沙市第一医院全科医学科,湖南长沙 410005
- 2. 云南省第一人民医院老年医学科,云南昆明 650032;昆明理工大学医学院,云南昆明 650032
- 折叠
摘要
目的 探索老年人血清D-二聚体、白蛋白及铁蛋白联合衰弱量表(Fried)对2型糖尿病(T2DM)并发肺部感染的预测价值.方法 选取2020年9月-2022年6月云南省第一人民医院老年医学科收治的312例患者为研究对象.收集患者的一般资料及血清生物学标志物,利用自主研发的"老年综合评估系统"对T2DM患者进行老年综合评估(CGA);最后筛查T2DM并发肺部感染的影响因素,并分析血清D-二聚体、白蛋白、铁蛋白联合Fried评分对T2DM并发肺部感染的预测价值.结果 312例老年T2DM患者,其中无肺部感染组180例(57.7％)、肺部感染组132例(42.3％),行二元Logistic回归分析,结果显示:衰弱期[OR=4.037,95％CI(2.105～7.743)]、白蛋白[OR=1.153,95％CI(1.080～1.233)]、铁蛋白[OR=1.002,95％CI(1.000～1.003)]、D-二聚体[OR=1.151,95％CI(1.016～1.303)]是老年T2DM患者并发肺部感染的影响因素(P＜0.05);此外,血清D-二聚体、白蛋白、铁蛋白联合衰弱状况对T2DM并发肺部感染的预测价值:曲线下面积(AUC)为0.811(95％CI:0.762～0.859),其临界值≥0.499时提示T2DM并发肺部感染,特异性为0.749,敏感度为0.750.结论 老年T2DM中肺部感染患病率高,血清D-二聚体、白蛋白、铁蛋白联合Fried评分有望成为T2DM并发肺部感染的预测指标.
Abstract
OBJECTIVE To explore the value of serum D-dimer,albumin and ferritin combined with Fried scores in prediction of pulmonary infection in elderly patients with type 2 diabetes mellitus(T2DM).METHODS A total of 312 patients who were treated in geriatrics department of Yunnan First People's Hospital from Sep 2020 to Jun 2022 were recruited as the research subjects.The baseline data and serum biological markers were collected from the patients.Comprehensive geriatric assessment(CGA)was carried out for the T2DM patients by the independ-ently developed'comprehensive assessment system for the elderly'.The influencing factors for the pulmonary in-fection in the T2DM patients were screened out,and the value of serum D-dimer,albumin and ferritin combined with Fried scores in prediction of the pulmonary infection was analyzed.RESULTS Among the 312 elderly patients with T2DM,there were 180(57.7％)patients without pulmonary infection and 132(42.3％)patients with pul-monary infection.The result of binary logistic regression analysis showed that frailty[OR=4.037,95％CI(2.105-7.743)],albumin[OR=1.153,95％CI(1.080-1.233)],ferritin[OR=1.002,95％CI(1.000-1.003)]and D-di-mer[OR=1.151,95％CI(1.016-1.303)]were the influencing factors for the pulmonary infection in the elderly patients with T2DM(P＜0.05).In addition,the area under curve(AUC)of the serum D-dimer,albumin,ferritin combined with Fried scores was 0.811(95％Cl:0.762-0.859)in prediction of the pulmonary infection in the T2DM patients,when the critical value was no less than 0.499,it suggested the pulmonary infection,with the specificity 0.749,the sensitivity 0.750.CONCLUSION The incidence of pulmonary infection is high among the elderly patients with T2DM.The serum D-dimer,albumin,ferritin combined with Fried scores is supposed to be an indicator for the prediction of pulmonary infection in the T2DM patients.
关键词
2型糖尿病/肺部感染/D-二聚体/白蛋白/铁蛋白/衰弱/老年综合评估/Fried衰弱量表Key words
Type 2 diabetes mellitus/Pulmonary infection/D-dimer/Albumin/Ferritin/Frailty/Comprehensive geriatric assessment/Fried score引用本文复制引用
基金项目
国家自然科学基金(81760109)
国家重点研发计划(2018YFC2002103)
云南省老年疾病临床医学研究中心项目(202102AA310069)
云南省董碧蓉专家工作站项目(202105AF150032)
长沙市自然科学基金(Kq22020210)
出版年
2024
NETL
NSTL
万方数据