海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
10期
1469-1472
,共4页
嗜铬粒蛋白A%重症监护患者%预后%预测价值
嗜鉻粒蛋白A%重癥鑑護患者%預後%預測價值
기락립단백A%중증감호환자%예후%예측개치
Chromogranin A%Intensive care patients%Prognosis%Predictive value
目的：探讨ICU重症患者入院后2 h内的血清嗜铬粒蛋白A (Chromogranin A，CGA)水平对患者死亡的预测价值。方法入选连续入住ICU、排除全身反应性疾病的急症危重患者80例(病例组)，同时选取健康对照者20例(对照组)，比较研究对象的CGA、降钙素原（Procalcitonin，PCT）、血肌酐、白细胞计数等水平，探讨CGA水平对患者预后及死亡的影响；连续观察随访30 d，记录分析死亡情况。结果病例组患者入院后2 h内的CGA、血肌酐、PCT、WBC等指标均明显高于健康对照组(P＜0.05)；CGA水平与血肌酐、PCT、WBC均呈正相关(P＜0.05)；CGA=136μg/L为截断值时，CGA对死亡的预测灵敏度、特异度均最高(P＜0.05)；CGA水平升高与较差的预后有关(P＜0.05)。结论急症危重患者入院后2 h内的血清CGA水平与病情的危重症程度、机体炎性反应水平呈正相关，对预测患者的死亡有效，较高的CGA水平与患者较差的预后有关，应开展该类患者CGA的早期监测，为临床决策提供依据。
目的：探討ICU重癥患者入院後2 h內的血清嗜鉻粒蛋白A (Chromogranin A，CGA)水平對患者死亡的預測價值。方法入選連續入住ICU、排除全身反應性疾病的急癥危重患者80例(病例組)，同時選取健康對照者20例(對照組)，比較研究對象的CGA、降鈣素原（Procalcitonin，PCT）、血肌酐、白細胞計數等水平，探討CGA水平對患者預後及死亡的影響；連續觀察隨訪30 d，記錄分析死亡情況。結果病例組患者入院後2 h內的CGA、血肌酐、PCT、WBC等指標均明顯高于健康對照組(P＜0.05)；CGA水平與血肌酐、PCT、WBC均呈正相關(P＜0.05)；CGA=136μg/L為截斷值時，CGA對死亡的預測靈敏度、特異度均最高(P＜0.05)；CGA水平升高與較差的預後有關(P＜0.05)。結論急癥危重患者入院後2 h內的血清CGA水平與病情的危重癥程度、機體炎性反應水平呈正相關，對預測患者的死亡有效，較高的CGA水平與患者較差的預後有關，應開展該類患者CGA的早期鑑測，為臨床決策提供依據。
목적：탐토ICU중증환자입원후2 h내적혈청기락립단백A (Chromogranin A，CGA)수평대환자사망적예측개치。방법입선련속입주ICU、배제전신반응성질병적급증위중환자80례(병례조)，동시선취건강대조자20례(대조조)，비교연구대상적CGA、강개소원（Procalcitonin，PCT）、혈기항、백세포계수등수평，탐토CGA수평대환자예후급사망적영향；련속관찰수방30 d，기록분석사망정황。결과병례조환자입원후2 h내적CGA、혈기항、PCT、WBC등지표균명현고우건강대조조(P＜0.05)；CGA수평여혈기항、PCT、WBC균정정상관(P＜0.05)；CGA=136μg/L위절단치시，CGA대사망적예측령민도、특이도균최고(P＜0.05)；CGA수평승고여교차적예후유관(P＜0.05)。결론급증위중환자입원후2 h내적혈청CGA수평여병정적위중증정도、궤체염성반응수평정정상관，대예측환자적사망유효，교고적CGA수평여환자교차적예후유관，응개전해류환자CGA적조기감측，위림상결책제공의거。
Objective To investigate the predictive value of serum chromogranin A concentration in 2h after admission for the mortality of acute critically ill patients.Methods 80 acute critically ill patients (observation group) and 20 health persons (control group) were compared with the CGA, procalcitonin (PCT), serum creatinine and white blood cell count. CGA levels were examined for 30 days and the death information were recorded. Effects of CGA lev-els was analyzed for the prognosis and mortality of the cases. Results CGA, serum creatinine , PCT, and WBC of the patients were significantly higher than that of the controls (P<0.05). There was a positive correlation among those four factors (P<0.05 ). When CGA was 136μg/L, the sensitivity and specificity of death prediction were the highest (P<0.05). The elevated CGA levels can predict poor prognosis (P<0.05). Conclusion The chromogranin A concentra-tion in 2h after admission of acute critically ill patients had a positive correlation with the body's inflammatory re-sponse levels which is effective to predict mortality of the patients. Higher CGA levels in patients have poor progno-sis. Early CGA monitoring should be carried out to provide a basis for clinical decision-making .
