摘要
目的研究前白蛋白(PA)、C反应蛋白(CRP)和D-二聚体(DD)的动态变化与慢性阻塞性肺疾病急性加重期(AECOPD)患者的病情严重度及预后的关系。方法测定96例慢性阻塞性肺疾病急性加重期患者入院第1、3、5d以及出院或死亡前最后一次的PA、CRP、DD、APACHEⅡ评分,按预后将患者分为死亡组及非死亡组进行动态观察,并做APACHEⅡ评分与PA、CRP、DD水平动态变化的相关性分析。结果死亡组与非死亡组入院后第1天PA、CRP和DD比较均无显著性差异,死亡组第3、5d、最后一次PA水平明显低于存活组(P<0.05),CRP和DD水平明显高于非死亡组(P<0.05)。PA与APACHEⅡ评分呈负相关(r=-0.631,P<0.01),CRP及DD与APACHEⅡ评分呈正相关(r=0.687,P<0.01和r=0.651,P<0.01)。结论 PA持续低水平、CRP和DD持续高水平提示病情危重,所以联合动态观察PA、CRP和DD对评估慢性阻塞性肺疾病急性加重期病情严重程度及预后有重要的临床意义。
Objective To study the changes of Prealbumin （ PA）, C - reactive protein （CRP） and D -dimer（DD） levels in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） so as to explore the relation to the severity of disease and prognosis. Methods PA, CRP and DD levels of 96 sepsis patients were measured on 1 st 3rd,5th day after admission and the last day before discharge or death. Meanwhile APACHE II score were documented. According to prognosis, patients were divided into death group and non - death group. Results The levels of PA, CRP and DD on 1 st day were of no significant difference between the death group and non - death group. The level of PA in death group was much lower than that in non - death group （P 〈 0. 05 ）. The level of CRP and DD in death group on 3rd day,5th day and the last day was much higher than that in non -death group （P 〈 0. 05）. There was a negative correlation between PA and APACHE 11 scores （r = - 0. 631 ,P 〈 0. 01 ）, while a positive correlation was found between CRP, DD and APACHE II score （r = 0. 687, P 〈 0.01 and r = 0. 651 ,P 〈 0. 01 ）. Conelusions Persistent low level of PA and high level of CRP and DD indicated severe disease course and unflavored prognosis, so it has important clinical value to evaluate the severity of disease and predict prognosis in sepsis by combined dynamic observation of PA, CRP and DD levels.
出处
《医药论坛杂志》
2011年第11期27-29,共3页
Journal of Medical Forum
