中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2015年
2期
222-223,227
,共3页
C反应蛋白%慢性阻塞性肺疾病急性发作期%急性生理学及慢性健康状况评分系统Ⅱ
C反應蛋白%慢性阻塞性肺疾病急性髮作期%急性生理學及慢性健康狀況評分繫統Ⅱ
C반응단백%만성조새성폐질병급성발작기%급성생이학급만성건강상황평분계통Ⅱ
C reactive protein%Acute exacerbation of chronic obstructive pulmonary disease%Acute physiology and chro-nic health evaluationⅡ
目的：探讨动态监测C反应蛋白（C‐reactive protein ，CRP）在行机械通气的慢性阻塞性肺疾病急性发作期（acute exacer‐bation of chronic obstructive pulmonary disease ，AECOPD）中的临床价值。方法：检测36例行机械通气的AECOPD患者入院后第1、3天的CRP ，记录入院时的动脉血气分析结果，采用急性生理学与慢性健康状况评分系统Ⅱ（APACHE Ⅱ）进行评分。根据患者预后情况分为生存组和病死组并进行比较。结果：两组性别、年龄差异无统计学意义（P＞0．05）。两组入院第1天CRP差异无统计学意义（P＞0．05），而第3天时CRP差异有统计学意义（P＜0．05）。两组的APACHEⅡ评分差异无统计学意义（P＞0．05）。两组入院时PaCO2差异有统计学意义（P＜0．05）。入院第1、3天CRP与APACHEⅡ评分无相关性（r1＝0．148，P1＝0．389；r3＝0．104，P3＝0．546）；入院第1天CRP与预后无相关性（r1＝－0．056，P1＝0．747），入院第3天CRP与预后呈正相关（r3＝0．364，P3＝0．029）；入院时PaCO2与预后无相关性（r＝－0．322，P＝0．056）。以CRP和APACHEⅡ评分作受试者工作特征（ROC）曲线，曲线下面积（AUC）分别为0．512、0．368。结论：CRP的动态变化对判断机械通气的AECO‐PD患者的病情严重程度和预后有一定价值。
目的：探討動態鑑測C反應蛋白（C‐reactive protein ，CRP）在行機械通氣的慢性阻塞性肺疾病急性髮作期（acute exacer‐bation of chronic obstructive pulmonary disease ，AECOPD）中的臨床價值。方法：檢測36例行機械通氣的AECOPD患者入院後第1、3天的CRP ，記錄入院時的動脈血氣分析結果，採用急性生理學與慢性健康狀況評分繫統Ⅱ（APACHE Ⅱ）進行評分。根據患者預後情況分為生存組和病死組併進行比較。結果：兩組性彆、年齡差異無統計學意義（P＞0．05）。兩組入院第1天CRP差異無統計學意義（P＞0．05），而第3天時CRP差異有統計學意義（P＜0．05）。兩組的APACHEⅡ評分差異無統計學意義（P＞0．05）。兩組入院時PaCO2差異有統計學意義（P＜0．05）。入院第1、3天CRP與APACHEⅡ評分無相關性（r1＝0．148，P1＝0．389；r3＝0．104，P3＝0．546）；入院第1天CRP與預後無相關性（r1＝－0．056，P1＝0．747），入院第3天CRP與預後呈正相關（r3＝0．364，P3＝0．029）；入院時PaCO2與預後無相關性（r＝－0．322，P＝0．056）。以CRP和APACHEⅡ評分作受試者工作特徵（ROC）麯線，麯線下麵積（AUC）分彆為0．512、0．368。結論：CRP的動態變化對判斷機械通氣的AECO‐PD患者的病情嚴重程度和預後有一定價值。
목적：탐토동태감측C반응단백（C‐reactive protein ，CRP）재행궤계통기적만성조새성폐질병급성발작기（acute exacer‐bation of chronic obstructive pulmonary disease ，AECOPD）중적림상개치。방법：검측36례행궤계통기적AECOPD환자입원후제1、3천적CRP ，기록입원시적동맥혈기분석결과，채용급성생이학여만성건강상황평분계통Ⅱ（APACHE Ⅱ）진행평분。근거환자예후정황분위생존조화병사조병진행비교。결과：량조성별、년령차이무통계학의의（P＞0．05）。량조입원제1천CRP차이무통계학의의（P＞0．05），이제3천시CRP차이유통계학의의（P＜0．05）。량조적APACHEⅡ평분차이무통계학의의（P＞0．05）。량조입원시PaCO2차이유통계학의의（P＜0．05）。입원제1、3천CRP여APACHEⅡ평분무상관성（r1＝0．148，P1＝0．389；r3＝0．104，P3＝0．546）；입원제1천CRP여예후무상관성（r1＝－0．056，P1＝0．747），입원제3천CRP여예후정정상관（r3＝0．364，P3＝0．029）；입원시PaCO2여예후무상관성（r＝－0．322，P＝0．056）。이CRP화APACHEⅡ평분작수시자공작특정（ROC）곡선，곡선하면적（AUC）분별위0．512、0．368。결론：CRP적동태변화대판단궤계통기적AECO‐PD환자적병정엄중정도화예후유일정개치。
Objective:To investigate the clinical value of dynamic monitoring of C reactive protein (CRP)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) under mechanical ventilation .Methods:The CRP levels were determined in 36 patients with AECOPD under mechanical ventilation at day 1 and day 3 after admission .The results of arterial blood gas analysis on admission were recorded .Acute physiology and chronic health evaluationⅡ (APACHEⅡ ) was used for scoring .Patients were divided into survival group and death group according to the prognosis ,and then compared with each other .Results:No statistically significant difference was found in age and sex between the two groups(P>0 .05) .There was no statis‐tically significant difference in CRP at day1 between the two groups(P>0 .05) ,while there was at day3(P<0 .05) .No statistically significant difference was found in APACHEⅡ scores between the two groups(P>0 .05) .There was statistically significant difference in PaCO2 between the two groups on admission .There was no correlation between CRP and APACHEⅡ scores(r1=0 .148 , P1=0 .389;r3=0 .104 ,P3= 0 .546) at day 1 and day 3 after admission .CRP at day 1 was not correlated with the prognosis(r1=-0 .056 ,P1=0 .747) .There were positive correlation between CRP at day 3 and the prognosis(r3=0 .364 ,P3=0 .029) .There was no correlation between PaCO2 on admission and the prognosis(r= -0 .322 ,P=0 .056) .The areas of CRP and APACHEⅡ scores un‐der the receiver operating characteristic(ROC) curve were 0 .512 and 0 .368 .Conclusions:Dynamic change of CRP contributes cer‐taln value to determining severity of illness and prognosis in patients with AECOPD under mechanical ventilation .
