■该研究的目的是描述鹦鹉病肺炎,并评估C反应蛋白/白蛋白比值对鹦鹉病肺炎严重程度的预测价值。
■使用宏基因组测序诊断的鹦鹉病肺炎病例数据来自上海的三家医院,中国从10月2019年10月2022年。测定血清C-反应蛋白和白蛋白水平,并计算C-反应蛋白与白蛋白的比值(CAR)。斯皮尔曼相关分析,有序逻辑回归分析,并进行受试者工作特征曲线分析,考察3项指标对病情严重程度的相关性和预测能力。
■共纳入27例鹦鹉病肺炎患者,平均年龄62岁,70.4%为男性。44.4%的患者有明确的禽类或禽类接触史。主要症状为发热(100%)。在呼吸重症监护病房(RICU)接受治疗的患者发生喘息的可能性更高(88.9%对33.3%,P=0.013)和胸闷(88.9%vs.33.3%,P=0.013)高于普通病房(非RICU)。RICU中胸腔积液患者的比例明显高于非RICU(88.9%vs.38.9%,P=0.019)。RICU组的CAR明显高于非RICU组(9.41vs.4.05,P=0.017)。这一结果伴随着更高的插管和呼吸机支持(33.3%vs.0.0%,P=0.029),RICU的PCT和CRP水平高于非RICU,白蛋白和PaCO2水平较低。Logistic回归分析显示,CAR(OR1.49;95%CI1.07~2.06,P=0.017)是住院时间延长(>14天)的危险因素。
■研究发现,血清CAR水平升高与严重鹦鹉病肺炎的风险增加相关。因此,它可以作为一个简单和有用的诊断工具,为临床医生迅速和准确地确定的严重程度的鹦鹉病肺炎,最终帮助他们制定最佳的治疗方案。
UNASSIGNED: The aim of the study was to describe psittacosis pneumonia and to assess the predictive value of the C-reactive protein/albumin ratio in psittacosis pneumonia for severity.
UNASSIGNED: Data on psittacosis pneumonia cases diagnosed using metagenomic sequencing were collected from three hospitals in Shanghai, China from Oct. 2019 to Oct. 2022. Serum levels of C-reactive protein and albumin were measured and the C-reactive protein to albumin ratio (CAR) was calculated. Spearman\'s correlation analysis, ordered logistic regression analysis, and receiver operating characteristic curve analysis were conducted to examine the correlation and predictive ability of the three indicators on the severity of the disease.
UNASSIGNED: A total of 27 patients with psittacosis pneumonia were enrolled, with an average age of 62 years and 70.4% being male. 44.4% of patients had a clear history of contact with poultry or birds. The predominant symptom was fever (100%). Patients treated in the respiratory intensive care unit (RICU) had a higher likelihood of experiencing wheezing (88.9% versus 33.3%, P=0.013) and chest tightness (88.9% vs. 33.3%, P=0.013) than those in the general ward (Non-RICU). The proportion of patients with pleural effusion was significantly higher in the RICU compared to the Non-RICU (88.9% vs. 38.9%, P=0.019). The RICU group had a significantly higher CAR than the Non-RICU group (9.41 vs. 4.05, P=0.017). This result was accompanied by higher intubation and ventilator support (33.3% vs. 0.0%, P=0.029), higher PCT and CRP levels and lower albumin and PaCO2 levels in the RICU than in the Non-RICU. Logistic regression analysis indicated that CAR (OR 1.49; 95% CI 1.07-2.06, P=0.017) was risk factor for prolonged hospitalization (> 14 days).
UNASSIGNED: Elevated serum CAR levels were found to be associated with a greater risk of severe psittacosis pneumonia. Consequently, it may serve as an uncomplicated and useful diagnostic tool for clinicians to promptly and precisely ascertain the severity of psittacosis pneumonia, ultimately aiding them in devising the most optimal therapeutic plan.