中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
8期
821-824
,共4页
朱一川%徐太静%沈建%任圣洁
硃一川%徐太靜%瀋建%任聖潔
주일천%서태정%침건%임골길
降钙素原%肾上腺髓质素%肺炎%老年人
降鈣素原%腎上腺髓質素%肺炎%老年人
강개소원%신상선수질소%폐염%노년인
Procalcitonin%Adrenomedullin%Pneumonia%The elderly
目的 探讨血清降钙素原(PCT)、肾上腺髓质素(ADM)浓度变化在老年肺炎患者诊断中的临床意义.方法 选择我院38例老年肺炎患者为研究组；另选择32例同期住院的呼吸科患者,包括肺部肿瘤、非感染性肺间质性疾病、肺水肿等呼吸道症状的非肺炎患者,设为对照组.依据CURB-65评分将研究组分为轻、中、重度3个亚组.ELISA法检测就诊患者第1、3、7天的血清PCT、ADM浓度并行统计分析.结果 就诊第1天,与对照组比较,研究组血清PCT[(1.98±0.32)、(1.63 ±0.44) ng/L,t=3.989,P=0.040)、ADM浓度[(0.92±0.31)、(0.52±0.12) μg/L,t=5.987,P＜0.001)显著升高.老年肺炎轻、中、重度3个亚组患者血清PCT、ADM浓度经过治疗后均有所下降,与轻、中度组比较,重度组各时间点的血清PCT[第1天:(2.19±0.36)、(1.80±0.28)、(1.83±0.22) ng/L,第3天:(2.08±0.34)、(1.73±0.35)、(1.75±0.24) ng/L；第7天:(2.05±0.32)、(1.65±0.30)、(1.61±0.31)ng/L]、ADM浓度[第1天:(1.08±0.31)、(0.80±0.25)、(0.77±0.22) μg/L;第3天:(1.09±0.32)、(0.77±0.23)、(0.75±0.21) μg/L；第7天:(1.08±0.33)、(0.66±0.18)、(0.72±0.25) μg/L]均显著升高(P均＜0.05).存活组患者血清PCT、ADM浓度就诊后第1、3、7天均显著低于死亡组患者[PCT:第1天:(1.82±0.26)、(2.16±0.37) ng/L；第3天:(1.74±0.29)、(2.06±0.31) ng/L；第7天:(1.62 ±0.30)、(2.03±0.30) ng/L；P均＜0.05.ADM:第1天:(0.78±0.23)、(1.06±0.29)μg/L；第3天:(0.76±0.21)、(1.08±0.30) μg/L;第7天:(0.70±0.20)、(1.09±0.35) μg/L;P均＜0.05],且死亡患者经过治疗后血清PCT与ADM浓度无明显变化.结论 血清PCT、ADM浓度可作为老年肺炎患者早期诊断、病情严重程度估计及预后判断的参考指标.
目的 探討血清降鈣素原(PCT)、腎上腺髓質素(ADM)濃度變化在老年肺炎患者診斷中的臨床意義.方法 選擇我院38例老年肺炎患者為研究組；另選擇32例同期住院的呼吸科患者,包括肺部腫瘤、非感染性肺間質性疾病、肺水腫等呼吸道癥狀的非肺炎患者,設為對照組.依據CURB-65評分將研究組分為輕、中、重度3箇亞組.ELISA法檢測就診患者第1、3、7天的血清PCT、ADM濃度併行統計分析.結果 就診第1天,與對照組比較,研究組血清PCT[(1.98±0.32)、(1.63 ±0.44) ng/L,t=3.989,P=0.040)、ADM濃度[(0.92±0.31)、(0.52±0.12) μg/L,t=5.987,P＜0.001)顯著升高.老年肺炎輕、中、重度3箇亞組患者血清PCT、ADM濃度經過治療後均有所下降,與輕、中度組比較,重度組各時間點的血清PCT[第1天:(2.19±0.36)、(1.80±0.28)、(1.83±0.22) ng/L,第3天:(2.08±0.34)、(1.73±0.35)、(1.75±0.24) ng/L；第7天:(2.05±0.32)、(1.65±0.30)、(1.61±0.31)ng/L]、ADM濃度[第1天:(1.08±0.31)、(0.80±0.25)、(0.77±0.22) μg/L;第3天:(1.09±0.32)、(0.77±0.23)、(0.75±0.21) μg/L；第7天:(1.08±0.33)、(0.66±0.18)、(0.72±0.25) μg/L]均顯著升高(P均＜0.05).存活組患者血清PCT、ADM濃度就診後第1、3、7天均顯著低于死亡組患者[PCT:第1天:(1.82±0.26)、(2.16±0.37) ng/L；第3天:(1.74±0.29)、(2.06±0.31) ng/L；第7天:(1.62 ±0.30)、(2.03±0.30) ng/L；P均＜0.05.ADM:第1天:(0.78±0.23)、(1.06±0.29)μg/L；第3天:(0.76±0.21)、(1.08±0.30) μg/L;第7天:(0.70±0.20)、(1.09±0.35) μg/L;P均＜0.05],且死亡患者經過治療後血清PCT與ADM濃度無明顯變化.結論 血清PCT、ADM濃度可作為老年肺炎患者早期診斷、病情嚴重程度估計及預後判斷的參攷指標.
목적 탐토혈청강개소원(PCT)、신상선수질소(ADM)농도변화재노년폐염환자진단중적림상의의.방법 선택아원38례노년폐염환자위연구조；령선택32례동기주원적호흡과환자,포괄폐부종류、비감염성폐간질성질병、폐수종등호흡도증상적비폐염환자,설위대조조.의거CURB-65평분장연구조분위경、중、중도3개아조.ELISA법검측취진환자제1、3、7천적혈청PCT、ADM농도병행통계분석.결과 취진제1천,여대조조비교,연구조혈청PCT[(1.98±0.32)、(1.63 ±0.44) ng/L,t=3.989,P=0.040)、ADM농도[(0.92±0.31)、(0.52±0.12) μg/L,t=5.987,P＜0.001)현저승고.노년폐염경、중、중도3개아조환자혈청PCT、ADM농도경과치료후균유소하강,여경、중도조비교,중도조각시간점적혈청PCT[제1천:(2.19±0.36)、(1.80±0.28)、(1.83±0.22) ng/L,제3천:(2.08±0.34)、(1.73±0.35)、(1.75±0.24) ng/L；제7천:(2.05±0.32)、(1.65±0.30)、(1.61±0.31)ng/L]、ADM농도[제1천:(1.08±0.31)、(0.80±0.25)、(0.77±0.22) μg/L;제3천:(1.09±0.32)、(0.77±0.23)、(0.75±0.21) μg/L；제7천:(1.08±0.33)、(0.66±0.18)、(0.72±0.25) μg/L]균현저승고(P균＜0.05).존활조환자혈청PCT、ADM농도취진후제1、3、7천균현저저우사망조환자[PCT:제1천:(1.82±0.26)、(2.16±0.37) ng/L；제3천:(1.74±0.29)、(2.06±0.31) ng/L；제7천:(1.62 ±0.30)、(2.03±0.30) ng/L；P균＜0.05.ADM:제1천:(0.78±0.23)、(1.06±0.29)μg/L；제3천:(0.76±0.21)、(1.08±0.30) μg/L;제7천:(0.70±0.20)、(1.09±0.35) μg/L;P균＜0.05],차사망환자경과치료후혈청PCT여ADM농도무명현변화.결론 혈청PCT、ADM농도가작위노년폐염환자조기진단、병정엄중정도고계급예후판단적삼고지표.
Objective To investigate the clinical significance of serun procalcitonin (PCT) and adrenomedullin(ADM) levels in elderly patients with pneumonia diagnosis.Methods Thirty-eight elderly patients with pneumonia who were admitted to our hospital were collected as the study group.Thirty-two cases of non-pneumonic patients hospitalized in respiratory department at the same period for lung tumor,non-infective interstitial lung diseases and pulmonary edema were chosen as the control group.According to CURB-65 score,the study group was divided into three subgroups as mild,moderate and severe group.Levels of serum PCT and ADM at the 1st day,3rd day and 7th day were measured by ELISA,and data were statistically analyzed.Results Serum PCT ((1.98 ± 0.32) μg/L vs.(1.63 ± 0.44) μg/L,t =3.989,P =0.040) and ADM levels ((0.92±0.31) μg/L vs.(0.52±0.12) μg/L,t =5.987,P ＜0.001) on the first day of the treatment was significantly higher than in the control group.Serum PCT and ADM levels in the three subgroups decreased after treatment,and at each time point serum PCT (1st day:(2.19 ±:0.36) μg/L vs.(1.80 ± 0.28) μg/L vs.(1.83 ±0.22) μg/L;3rd day:(2.08 ±0.34) μg/L vs.(1.73 ±0.35) μg/L vs.(1.75 ±0.24) μg/L;7th day:(2.05 ±0.32) μg/L vs.(1.65 ±0.30) μg/L vs.(1.61 ±0.31) μg/L) and ADM levels (1st day:(1.08 ± 0.31) μg/L vs.(0.80 ± 0.25) μg/L vs.(0.77 ± 0.22) μg/L; 3rd day:(1.09 ± 0.32) μg/L vs.(0.77 ±0.23) μg/L vs.(0.75 ±0.21) μg/L;7th day:(1.08 ±0.33) μg/L vs.(0.66 ±0.18) μg/L vs.(0.72 ±0.25) μg/L) in the severe group were significantly higher than in the other two subgroups (P ＜0.05).Serum PCT and ADM levels in survived patients on the 1 st day,3rd day,and 7th day after treatment were significantly lower than in patients who were deceased (PCT:1 st day:(1.82 ± 0.26) μg/L vs.(2.16 ± 0.37)μg/L;3rd day:(1.74 ± 0.29) ~L vs.(2.06 ±0.31) μg/L;7th day:(1.62 ± 0.30) μg/L vs.(2.03 ±0.30) μg/L;P ＜0.05 ;ADM:1st day:(0.78 ± 0.23) μg/L vs.(1.06 ± 0.29) μg/L;3rd day:(076 ± 0.21)μg/L vs.(1.08 ± 0.30) μg/L; 7 th day:(0.70 ± 0.20) μg/L vs.(1.09 ± 0.35) μg/L; P ＜ 0.05),and serum PCT and ADM levels did not change significantly in deceased patients after treatment.Conclusion Serum PCT and ADM levels can serve as serum markers in early diagnosis,the severity of pneumonia and estimating prognosis in elderly patients.
