CAJ | 학술논문

目的：观察重症肺炎APACHE II评分及血D-乳酸水平的变化，并分析其与疾病严重程度的关系，判断重症肺炎肠黏膜屏障功能的改变。方法选择40例重症肺炎患者（ A组），另选择同期25例普通肺炎患者作为B组，健康人群25例作为C组。在患者入组时抽血测D-乳酸水平，测APACHE评分，并对检测结果进行统计学分析。结果重症肺炎组患者D-乳酸水平明显高于普通肺炎组和健康对照组，差异有统计学意义（ P＝0.011，0.016）；普通肺炎组D-乳酸水平高于健康对照组（ P＝0.034）；重症肺炎组患者APACHE II评分与D-乳酸呈线性正相关（[apache评分]＝[D-乳酸]*9.753-52．948）。结论重症肺炎患者肠黏膜屏障功能均有不同程度损伤，随病情的加重而损伤程度加重，早期保护肠黏膜屏障功能对改善重症肺炎预后有积极的意义。
목적：관찰중증폐염APACHE II평분급혈D-유산수평적변화，병분석기여질병엄중정도적관계，판단중증폐염장점막병장공능적개변。방법선택40례중증폐염환자（ A조），령선택동기25례보통폐염환자작위B조，건강인군25례작위C조。재환자입조시추혈측D-유산수평，측APACHE평분，병대검측결과진행통계학분석。결과중증폐염조환자D-유산수평명현고우보통폐염조화건강대조조，차이유통계학의의（ P＝0.011，0.016）；보통폐염조D-유산수평고우건강대조조（ P＝0.034）；중증폐염조환자APACHE II평분여D-유산정선성정상관（[apache평분]＝[D-유산]*9.753-52．948）。결론중증폐염환자장점막병장공능균유불동정도손상，수병정적가중이손상정도가중，조기보호장점막병장공능대개선중증폐염예후유적겁적의의。
Objective To observe the changes of D-lactic acid level and APACHE II in patients with serious pneumonia ,and ana-lyze the relationship among them ,judging the changes of intestinal mucosal barrier function with severe pneumonia .Methods 40 cases of severe pneumonia patients were selected as group A ,25 patients with common pneumonia as group B ,25 cases of healthy people as group C.D-lactic acid blood and APACHE II score were measured on the first day when patients were into the groups and the results were statistical analyzed .Results D-lactic acid level in patients with severe pneumonia group is significantly higher than ordinary pneumonia group and healthy control group , the differences were statistically significant (P=0.011,0.016).D-lactic acid level in pa-tients with common pneumonia group had higher than the healthy controls (P=0.034).APACHE II score and D-lactic acid had linear positive correlation in severe pneumonia group .Conclusion Intestinal mucosal barrier function in patients with severe pneumonia is in-jured,along with the increase of disease damage degree ,early protection for the intestinal mucosal barrier function has positive signifi-cance for improving the prognosis of severe pneumonia .