文章摘要
王志伟,韩秀迪,孙怡,等.血尿素氮与白蛋白比值评估老年社区获得性肺炎患者病情严重程度和预后的价值[J].中国临床保健杂志,2025,28(5):653-658.
血尿素氮与白蛋白比值评估老年社区获得性肺炎患者病情严重程度和预后的价值
Evaluating the diagnostic value of blood urea nitrogen-to-albumin ratio for disease severity and prognosis in elderly patients with community-acquired pneumonia
投稿时间：2025-06-22  
DOI：10.3969/J.issn.1672-6790.2025.05.014
中文关键词: 肺炎  交叉感染  社区获得性感染  血尿素氮  白蛋白类  老年人 DOI:10.3969/J.issn.1672-6790.2025.05.014Evaluating the diagnostic value of blood urea nitrogen-to-albumin ratio for disease severity and prognosis in elderly patients with community-acquired pneumonia WANG Zhiwei,HAN Xiudi,SUN Yi,TENG Peikun,WANG Hong,ZHANG Xingyu,LIU Xuedong
英文关键词: Pneumonia  Cross infection  Community-acquired infections  Blood urea nitrogen  Albumins  Aged 〖FL
基金项目:山东省青岛市科技惠民示范专项(24-1-8-smjk-13-nsh)
作者单位E-mail
王志伟 山东第二医科大学临床医学院,山东潍坊 261053 xuedongliu@263.net 
韩秀迪 青岛市市立医院,呼吸与危重症医学科,山东青岛 266011 xuedongliu@263.net 
孙怡 青岛市市立医院,呼吸与危重症医学科,山东青岛 266011 xuedongliu@263.net 
滕佩坤 青岛市市立医院,呼吸与危重症医学科,山东青岛 266011 xuedongliu@263.net 
王虹 青岛市市立医院,院感科,山东青岛 266011 xuedongliu@263.net 
张兴宇 青岛市市立医院,人事部,山东青岛 266011 xuedongliu@263.net 
刘学东 青岛市市立医院,呼吸与危重症医学科,山东青岛 266011 xuedongliu@263.net 
摘要点击次数: 41
全文下载次数: 26
中文摘要:
      目的 探讨血尿素氮与白蛋白比值(BAR)评估老年社区获得性肺炎(CAP)患者病情严重程度和预后的价值。方法 采用回顾性研究。选取2020年11月18日至2021年11月21日在青岛市市立医院住院治疗的208例老年CAP患者病历资料,根据入院时病情严重程度将患者分为非重症社区获得性肺炎(NSCAP)组和重症社区获得性肺炎(SCAP)组,并根据随访出院后1年患者的生存情况,将患者进一步分为生存组与死亡组。记录患者的人口学和临床资料。使用受试者工作特征曲线分析并比较BAR和其他临床参数诊断SCAP和NSCAP及患者1年内死亡的预测性能,采用多因素logistic回归分析老年SCAP和患者1年全因死亡的独立危险因素。结果 在病情严重程度方面,SCAP组患者的BAR、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、CURB-65评分及肺炎严重指数分级均高于NSCAP组,而淋巴细胞计数(LYM)低于NSCAP组(均P＜0.05)。多因素logistic回归显示,性别、年龄、糖尿病史和BAR是发生SCAP的独立危险因素。BAR预测SCAP的曲线下面积(AUC)为0.841,最佳截断值为5.92 mg/g,敏感度为82.8%,特异度为76.5%,其预测性能优于PCT和CRP。在预后方面,死亡组患者的WBC、PCT、血尿素氮、BAR均高于生存组,而白蛋白和LYM低于生存组,差异均有统计学意义(均P＜0.05)。BAR预测1年内死亡的AUC为0.820,最佳截断值为7.66 mg/g,敏感度为66.7%,特异度为86.9%。多因素logistic分析显示,合并慢性阻塞性肺疾病、BAR和WBC是老年CAP患者1年全因死亡的独立危险因素。结论 BAR不仅是SCAP发生的独立危险因素,也是1年全因死亡的较强预测因子,其预测效能显著优于传统炎症标志物CRP和PCT。
英文摘要:
      Objective To explore the value of the Blood Urea Nitrogen to Albumin Ratio (BAR) in assessing disease severity and predicting prognosis in elderly patients with community-acquired pneumonia (CAP).Methods Retrospective study.A total of 208 elderly CAP patients hospitalized at Qingdao Municipal Hospital between November 18,2020 and November 21,2021 were included.Based on the severity of their conditions at admission,patients were categorized into the non-severe community-acquired pneumonia (NSCAP) group and the severe community-acquired pneumonia (SCAP) group,According to one-year survival status after discharge,they were further divided into survival and death groups.Demographic and clinical data were collected.Receiver Operating Characteristic (ROC) curve analysis was used to evaluate and compare the performance of BAR and other clinical parameters in predicting SCAP and one-year mortality.Logistic regression was performed to identify independent risk factors for SCAP and one-year all-cause mortality.Results Regarding disease severity,the SCAP group showed significantly higher BAR,white blood cell count (WBC),C-reactive protein (CRP),procalcitonin (PCT),CURB-65 score,and Pneumonia Severity Index grade compared to the NSCAP group.In contrast,lymphocyte count (LYM) was significantly lower (all P<0.05).Multivariate analysis indicated that gender,age,history of diabetes,and BAR were independent risk factors for SCAP.BAR predicted SCAP with an AUC of 0.841.The optimal cutoff value was 5.92 mg/g,with a sensitivity of 82.8% and specificity of 76.5%.BAR demonstrated better predictive performance than PCT and CRP.In terms of prognosis,the death group had higher WBC,PCT,blood urea nitrogen (BUN),and BAR levels than the survival group.Albumin and LYM were lower in the death group (all P<0.05).BAR predicted one-year mortality with an AUC of 0.820.The optimal cutoff was 7.66 mg/g,yielding a sensitivity of 66.7% and specificity of 86.9%.Multivariate analysis revealed that comorbid chronic obstructive pulmonary disease,BAR,and WBC were independent risk factors for one-year all-cause mortality.Conclusions BAR is not only an independent risk factor for SCAP,but also a strong predictor of all-cause mortality at 1 year,with significantly better predictive performance than traditional inflammatory markers CRP and PCT.
查看全文     
关闭
分享按钮