摘要
目的探讨老年人肺部感染致多器官功能障碍血清胆碱酯酶(CHE)水平变化及与预后的关系,以期为该病诊治及病情监测提供依据。方法以2009年1月-2011年12月住院老年肺部感染导致多脏器功能障碍综合征患者100例为研究对象,随机抽取同期健康体检老年患者40例为对照组,应用丁酰硫代胆碱法分别测定对照组、多器官功能障碍组、肝功能不全组CHE水平。结果对照组血清CHE水平为(7800.03±1632.78)IU/L,肺部感染致多器官功能障碍组CHE水平为(4072.98±2396.36)IU/L,其中肝功能不全组为(4734.79±2445.64)IU/L,较对照组均明显降低(P<0.05);对照组CHE异常比例为0.00%,老年多器官功能障碍组、肝功能不全组分别为:71.00%和54.16%,较对照组均明显升高(P<0.05);按照预后将老年肺部感染致多器官功能障碍患者分为生存组与死亡组,生存组CHE水平为(4771.06±2431.42)IU/L,而死亡组则为(2387.96±1259.58)IU/L,死亡组较生存组明显降低(P<0.05);生存组CHE异常比例为59.20%,而死亡组达96.60%,死亡组较生存组明显升高(P<0.05)。结论老年肺部感染致多器官功能障碍患者血清CHE水平显著降低,其降低程度可能与预后相关,可作为患者病情监测、治疗与预后判断的综合指标。
OBJECTIVE To investigate the changes of serum cholinesterase（CHE） and predictive value for elderly patients with multiple organs dysfunction induced by pulmonary infections so as to guide the diagnosis and treatment of the disease and the monitoring of the condition, METHODS A total of 100 hospitalized elderly patients with MODSE induced by pulmonary infections between Jan 2009 and Dec 2011 were enrolled in the study. Other 40 healthy elderly persons were set as the control group. The serum CHE were measured by S-Butyrylthiocholine iodide method in senile patients. RESULTS Compared with the control group, the serum cholinesterase level of MODSE induced by pulmonary infection was significantly decreased （4072. 98±2396. 36） IU/L vs （7800. 03 ±1632.78）IU/L,（P〈0.05）. The serum cholinesterase of liver dysfunction patients was also decreased （4734.79 ±2445.64）IU/L vs （7800.03±1632.78） IU/L, P〈0.05）. None of CHE was abnormal in the control group. The abnormal rates of CHE in the patients with MODSE induced by pulmonary infection and with liver dysfunction were 71.00% and 54. 16%, respectively. Both of them were comparatively elevated compared with the control group （P〈0.05）. Dividing into groups according to prognostic of patients, the serum cholinesterase concentration of the death group was significantly reduced compared with the survival group（2387. 96±1259. 58 ）IU/L vs （4771.06±2431.42）IU/L, （P〈0.05）. The abnormal rate of CHE in death group was comparatively higher than that of the survival group（96.60% vs 59.20%）, （P〈0.05）. CONCLUSION The level of cholinesterase is closely correlated with the outcome of MODSE induced by pulmonary infections, lower cholinesterase is often associated with the poor outcomes. Serum cholinesterase maybe a useful biomarker for the treatment and prognosis in clinical practice.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2518-2520,共3页
Chinese Journal of Nosocomiology
基金
武警总医院2类课题(WZ2012034)
关键词
老年
肺部感染
多器官功能障碍
胆碱酯酶
预后
Elderly
Pulmonary infection
Multiple organs dysfunction syndrome
Cholinesterase
Prognosis
