| 哈迪娜·热马赞 张建军 王晓敏 沙米啦·吐尔逊 喻露.老年重症肺炎接受机械通气患者血清超敏C反应蛋白与短期预后的关系[J].,2016,16(26):5077-5080 |
| 老年重症肺炎接受机械通气患者血清超敏C反应蛋白与短期预后的关系 |
| Relationship of SerumHypersensitive C-reactive Protein and Short-termPrognosis in Severe Pneumonia Patients Receiving Mechanical Ventilation* |
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| DOI： |
| 中文关键词: 超敏C 反应蛋白 重症肺炎 机械通气 |
| 英文关键词: Hypersensitive c-reactive protein Severe pneumonia Mechanical ventilation |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2014211A053） |
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| 中文摘要: |
| 目的：探讨老年重症肺炎接受机械通气患者血清超敏C 反应蛋白(hs-CRP)与短期预后的关系。方法：将97 例老年重症肺炎
接受机械通气治疗的患者按照入院第28h 的预后分为死亡组(n=34 例) 和存活组(n=63 例)，同时按照肺炎严重指数(PSI)和
CURB-65 评分将患者分为Ⅳ级组(90～130 分)(n=29 例) 和V 级组(＞130 分) (n=68 例)；CURB-65 评分2 分组(n=31 例)和
CURB-65 评分3～5 分组(n=66 例)；比较各组患者相关临床指标、入院第1 d、3 d、7 d的血清hs-CRP 水平的差异，分析血清
hs-CRP水平与近期预后的关系。结果：死亡组与存活组患者在机械通气时间、CURB-65 评分、PSI、血清白蛋白(ALB)、降钙素原
(PCT)、血乳酸(Lac)方面存在统计学差异(P＜0.05)；死亡组患者入院第1 d、3 d、7 d的血清hs-CRP 水平显著高于死亡组(P＜0.05)；
PSI中V 级组，CURB-65 评分3～5 分组中入院第1 d、3 d、7 d的血清hs-CRP 水平亦高于Ⅳ级组和CURB-65 评分2 分组。血清
hs-CRP 水平是患者近期死亡的独立危险因素。入院后第1 d、3 d、7 d的血清hs-CRP 水平患者死亡的ROCAUC 分别为0.844、
0.914、0.772，最佳诊断截点分别为51.76 mg/L、92.56 mg/L 及49.38 mg/L。结论：血清hs-CRP 水平是老年重症肺炎接受机械通气
患者近期死亡的独立危险因素，动态检测血清hs-CRP 变化对评估患者预后具有一定的临床意义。 |
| 英文摘要: |
| Objective:To investigate the relationship of serum hypersensitive c-reactive protein (hs-CRP) with the short-term
prognosis of elderly severe pneumonia patients after mechanical ventilation.Methods:Ninety-seven elderly patients with severe
pneumonia undergoing mechanical ventilation treatment in our hospital were divided into the death group (n = 34) and survival group (n
= 63) according to the prognosis of 28 h on admission. At the same time, according to the pneumonia severity index (PSI), they were
divided into level Ⅳ group (90 ~ 130) (n = 29) and level V group (> 130 points) (n = 68). Meanwhile, according to the CURB-65 scores,
they were divided into grade 2 group (n = 31 cases) and the grade 3 ~ 5 group (n = 66). Compare the related clinical indicators,
differences of serum hs-CRP levels at 1 d, 3 d, 7 d after admission between groups, and analyze the relationship of serum hs-CRP levels
and recent prognosis.Results:There were statistically significant differences between patients in death group and survival group in
mechanical ventilation time, CURB-65 score, PSI, serum albumin (propagated), calcitonin (PCT) and blood lactic acid (Lac) (P <0.05).
Patients in death group had higher serumhs-CRP levels than in on 1 d, 3 d, 7 d after admission (P <0.05). The serum hs-CRP levels were
also higher in PSI V level group and the group with 3 ~ 5 scores of CURB-65 than in PSI Ⅳ group and the group with 2 scores of
CURB-65 on 1 d, 3 d, 7 d after admission (P<0.05). The serum hs-CRP level was the independent risk factor of patients with a recent
death. ROC curve analysis showed that the serum hs- CRP levels ROCAUC of death in patients on 1 d, 3 d, 7 d after admission were
respectively 0.844, 0.914, 0.772, and the best diagnostic cutoff point were 51.76 mg/L, 92.56 mg/L and 49.38 mg/L.Conclusion:The
serum hs-CRP level was the independent risk factor of recent death for severe pneumonia patients with mechanical ventilation. Dynamic
detection of serumhs-CRP had clinical significance in the prognosis of patients. |
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