CAJ | 학술논문

目的观察社区获得性肺炎(CAP)患者血清丙二醛(MDA)和血清总抗氧化力(T-AOC)水平的变化,探讨其临床意义.方法以徐州医学院附属医院呼吸科2010年9月-2011年9月收治的90例CAP患者[男54例,女36例,平均年龄(54±20)岁]和30名同期在我院体检健康者[男20名,女10名,平均年龄(52±11)岁]为研究对象.CAP患者进行肺炎严重指数(PSI)评分,将其分为Ⅰ～Ⅲ级低危险组46例,Ⅳ～Ⅴ级为高危险组44例；检测血清MDA和血清T-AOC水平.组间采用t检验或者x2检验；CAP组中根据患者存活或死亡的转归,进行Logistic回归分析.结果 CAP组血清MDA[(6.5±2.4) μmol/L]高于对照组[(3.6±0.3)μmol/L]；CAP组血清T-AOC[(12.6±1.6) U/ml]低于对照组[(17.7±2.1) U/ml];高危险组及死亡组血清MDA[(8.1±2.5) μmol/L;(9.9±1.6)μmol/L]高于低危险组及存活组[(4.9±0.7) μmol/L;(6.1±2.2)μmol/L]；高危险组及死亡组血清T-AOC[(11.5±1.6) U/ml;(10.6±1.5)U/ml]低于低危险组及存活组[(13.6±0.6) U/ml;(12.8±1.4) U/ml];血清MDA与PSI评分呈正相关,相关系数为0.745;差异均有统计学意义(P＜0.05).经过有效治疗后血清MDA水平总体呈下降趋势,血清T-AOC呈上升趋势.Logistic回归分析血清MDA是影响CAP患者预后的危险因素.结论 CAP患者血清MDA水平能够反应病情的严重程度及判断预后.动态监测血清MDA和T-AOC水平可以帮助判断治疗效果.
목적 관찰사구획득성폐염(CAP)환자혈청병이철(MDA)화혈청총항양화력(T-AOC)수평적변화,탐토기림상의의.방법 이서주의학원부속의원호흡과2010년9월-2011년9월수치적90례CAP환자[남54례,녀36례,평균년령(54±20)세]화30명동기재아원체검건강자[남20명,녀10명,평균년령(52±11)세]위연구대상.CAP환자진행폐염엄중지수(PSI)평분,장기분위Ⅰ～Ⅲ급저위험조46례,Ⅳ～Ⅴ급위고위험조44례；검측혈청MDA화혈청T-AOC수평.조간채용t검험혹자x2검험；CAP조중근거환자존활혹사망적전귀,진행Logistic회귀분석.결과 CAP조혈청MDA[(6.5±2.4) μmol/L]고우대조조[(3.6±0.3)μmol/L]；CAP조혈청T-AOC[(12.6±1.6) U/ml]저우대조조[(17.7±2.1) U/ml];고위험조급사망조혈청MDA[(8.1±2.5) μmol/L;(9.9±1.6)μmol/L]고우저위험조급존활조[(4.9±0.7) μmol/L;(6.1±2.2)μmol/L]；고위험조급사망조혈청T-AOC[(11.5±1.6) U/ml;(10.6±1.5)U/ml]저우저위험조급존활조[(13.6±0.6) U/ml;(12.8±1.4) U/ml];혈청MDA여PSI평분정정상관,상관계수위0.745;차이균유통계학의의(P＜0.05).경과유효치료후혈청MDA수평총체정하강추세,혈청T-AOC정상승추세.Logistic회귀분석혈청MDA시영향CAP환자예후적위험인소.결론 CAP환자혈청MDA수평능구반응병정적엄중정도급판단예후.동태감측혈청MDA화T-AOC수평가이방조판단치료효과.
Objective To observed serum malondialdehyde(MDA) and total antioxidative capacity (T-AOC) in patients with CAP and to explore their clinical significance.Methods 90 cases of hospitalized CAP (including 54 males and 36 females with a mean age of 54± 20 years) were recruited from the respiratory wards in the affiliated Hospital of Xuzhou Medical College from September 2010 to September 2011 and 30 cases (including 20 males and 10 females with a mean age of 52 ±-11 years) of healthy physical examination in our hospital served as the control.We collected clinical variables of all patients after they were hospitalized within 24 hours and calculated PSI score.The CAP patients were divided into 2 groups:grade Ⅰ-Ⅲ as the low-risk group (n＝46) and grade Ⅳ-Ⅴ as the high-risk group (n＝44)according to PSI score.Serum MDA and total T-AOC were also measured.We adopted t test or x2 test in the comparison between the groups.And performed the logistic regression analysis and found independent risk factors which had important effect on clinical.Results Serum MDA concentration of CAP patients [(6.5±2.4) μmol/L],the high-risk group [(8.1 ± 2.5) μmol/L] and the death group [(9.9 ± 1.6)μmol/L] were significantly higher than those of the control group [(3.6± 0.3) μmol/L],the low-risk group [(4.9 ± 0.7) μmol/L] and the survival group [(6.1 ± 2.2) tmol/L].Serum T-AOC concentration of CAP patients [(12.6± 1.6) U/ml],the high-risk group [(11.5 ± 1.6) U/ml] and the death group [(10.6-1.5) U/ml]were significantly lower than those of the control group [(17.7 ± 2.1)U/ml],the low-risk group [(13.6 ± 0.6) U/ml] and the survival group [(12.8 ± 1.4) U/ml] (P ＜0.05,respectively).There were positive correlation between the serum MDA and PSI score (r =0.745) (P ＜0.05).Serum MDA concentration of the survival patients after the treatment were significantly lower than those before the treatment.Serum T-AOC concentration of the survival patients after the treatment were significantly higher than those before the treatment.We performed the logistic regression analysis and found that serum MDA concentration could reflect the prognosis.Conclusions The serum MDA concentration could reflect the severity and the prognosis of CAP.The dynamic changes of serum MDA concentration and serum T-AOC concentration in patients with CAP could be used for judging the treatment efficacy.