中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2010年
19期
26-28,32
,共4页
肺炎%社区获得性%血清合肽素%动脉血气分析
肺炎%社區穫得性%血清閤肽素%動脈血氣分析
폐염%사구획득성%혈청합태소%동맥혈기분석
Pneumonia%Community-acquire%Serum copeptin%Arterial blood gas analysis
目的 探讨社区获得性肺炎(CAP)老年患者血清合肽素的临床意义.方法 收集河南省人民医院呼吸科病房2009年1月至12月入院的68例年龄>65岁的CAP患者,男36例,女32例,平均年龄(70±5)岁;对照组为年龄>65岁的30名健康体检者,男15名,女15名,平均年龄(68±3)岁.68例CAP患者诊断依据及入院治疗标准符合中华医学会呼吸病学分会制定的"社区获得性肺炎诊断和治疗指南".按肺炎严重指数(PSI)将患者分为:Ⅰ～Ⅲ级组25例,Ⅳ级组23例,Ⅴ级组20例.测定肺炎患者治疗前后及对照组的血清合肽素、血常规、血清超敏C反应蛋白、动脉血氧饱和度(PaO2)及氧合指数(PaO2/FiO2),比较四组相关数值的差异.组间比较采用q检验,治疗前后的比较采用组内配对t检验.结果 治疗前V级肺炎患者血清合肽素为(1.25±0.18)μg/L,明显高于Ⅳ级肺炎患者的(0.76±0.16)μg/L;Ⅰ～Ⅲ级肺炎患者的(0.38±0.08)μg/L及对照组的(0.12±0.02)μg/L;治疗后V级、Ⅳ级、Ⅰ～Ⅲ级肺炎患者血清合肽素分别为(0.18±0.06)μg/L、(0.11±0.05)μg/L和(0.08±0.02)μg/L,均较治疗前显著降低.治疗前肺炎患者血清超敏C反应蛋白、白细胞总数均明显高于对照组,治疗后明显下降.治疗前V级肺炎患者PaO2、PaO2/FiO2均明显低于Ⅳ级、Ⅰ～Ⅲ级肺炎患者及对照组,治疗后明显升高.结论 血清合肽素可作为判断社区获得性肺炎老年患者治疗疗效的一项指标.
目的 探討社區穫得性肺炎(CAP)老年患者血清閤肽素的臨床意義.方法 收集河南省人民醫院呼吸科病房2009年1月至12月入院的68例年齡>65歲的CAP患者,男36例,女32例,平均年齡(70±5)歲;對照組為年齡>65歲的30名健康體檢者,男15名,女15名,平均年齡(68±3)歲.68例CAP患者診斷依據及入院治療標準符閤中華醫學會呼吸病學分會製定的"社區穫得性肺炎診斷和治療指南".按肺炎嚴重指數(PSI)將患者分為:Ⅰ～Ⅲ級組25例,Ⅳ級組23例,Ⅴ級組20例.測定肺炎患者治療前後及對照組的血清閤肽素、血常規、血清超敏C反應蛋白、動脈血氧飽和度(PaO2)及氧閤指數(PaO2/FiO2),比較四組相關數值的差異.組間比較採用q檢驗,治療前後的比較採用組內配對t檢驗.結果 治療前V級肺炎患者血清閤肽素為(1.25±0.18)μg/L,明顯高于Ⅳ級肺炎患者的(0.76±0.16)μg/L;Ⅰ～Ⅲ級肺炎患者的(0.38±0.08)μg/L及對照組的(0.12±0.02)μg/L;治療後V級、Ⅳ級、Ⅰ～Ⅲ級肺炎患者血清閤肽素分彆為(0.18±0.06)μg/L、(0.11±0.05)μg/L和(0.08±0.02)μg/L,均較治療前顯著降低.治療前肺炎患者血清超敏C反應蛋白、白細胞總數均明顯高于對照組,治療後明顯下降.治療前V級肺炎患者PaO2、PaO2/FiO2均明顯低于Ⅳ級、Ⅰ～Ⅲ級肺炎患者及對照組,治療後明顯升高.結論 血清閤肽素可作為判斷社區穫得性肺炎老年患者治療療效的一項指標.
목적 탐토사구획득성폐염(CAP)노년환자혈청합태소적림상의의.방법 수집하남성인민의원호흡과병방2009년1월지12월입원적68례년령>65세적CAP환자,남36례,녀32례,평균년령(70±5)세;대조조위년령>65세적30명건강체검자,남15명,녀15명,평균년령(68±3)세.68례CAP환자진단의거급입원치료표준부합중화의학회호흡병학분회제정적"사구획득성폐염진단화치료지남".안폐염엄중지수(PSI)장환자분위:Ⅰ～Ⅲ급조25례,Ⅳ급조23례,Ⅴ급조20례.측정폐염환자치료전후급대조조적혈청합태소、혈상규、혈청초민C반응단백、동맥혈양포화도(PaO2)급양합지수(PaO2/FiO2),비교사조상관수치적차이.조간비교채용q검험,치료전후적비교채용조내배대t검험.결과 치료전V급폐염환자혈청합태소위(1.25±0.18)μg/L,명현고우Ⅳ급폐염환자적(0.76±0.16)μg/L;Ⅰ～Ⅲ급폐염환자적(0.38±0.08)μg/L급대조조적(0.12±0.02)μg/L;치료후V급、Ⅳ급、Ⅰ～Ⅲ급폐염환자혈청합태소분별위(0.18±0.06)μg/L、(0.11±0.05)μg/L화(0.08±0.02)μg/L,균교치료전현저강저.치료전폐염환자혈청초민C반응단백、백세포총수균명현고우대조조,치료후명현하강.치료전V급폐염환자PaO2、PaO2/FiO2균명현저우Ⅳ급、Ⅰ～Ⅲ급폐염환자급대조조,치료후명현승고.결론 혈청합태소가작위판단사구획득성폐염노년환자치료료효적일항지표.
Objective To study the clinical significance of serum copeptin in elderly patients with community-acquired pneumonia (CAP). Methods Sixty-eight cases of hospitalized CAP including 36 males and 32 females with a mean age of (70±5) years were recruited from the respiratory wards in the Henan province hospital from January 2009 to December 2009.Thirty healthy volunteers including 15 males and 15 females with a mean age of (68±3) years served as the control.The CAP patients were divided into 3 groups: grade Ⅰ-Ⅲ(n=25),grade Ⅳ(n=23) and grade Ⅴ(n=20) according to pneumonia severity index (PIS). Results Serum copeptin concentration of the grade Ⅴ patients [(1.25±0.18)μg/L] was significantly higher than those of the grade Ⅳ patients [(0.76±0.16) μg/L], grade Ⅰ-Ⅲ patients [(0.38±0.08) μg/L] and the control group[(0.12±0.02) μg/L] before the treatment.Serum copeptin concentration of the grade Ⅴ patients [(0.18±0.06) μg/L],grade Ⅳ patients [(0.11±0.05) μg/L],and grade Ⅰ-Ⅲ patients [(0.08±0.02) μg/L] after the treatment were significantly lower than those before the treatment.Serum high-sensitivity C-reactive protein and the total number of while blood cells of the patients with CAP were significantly higher than those of the control group before the treatment. Serum high-sensitivity C-reactive protein and total number of while blood cells of the patients with CAP were significantly decreased after the treatment.PaO2/FiO2 of the grade Ⅴ patients were significantly lower than of the grade Ⅳpatients, grade Ⅰ-Ⅲ patients and the control group before the treatment, and were significantly increased after the treatment. Conclusions Serum copeptin could be used as an inflammatory marker for judging the treatment efficacy in elderly patients with CAP.
