摘要
目的:探讨动态监测血乳酸(LAC)和胆碱酯酶(CHE)、前白蛋白(PA)水平对判断老年重症肺炎患者病情严重程度及预后的意义。方法:40例老年重症肺炎患者入院后第1、4、7天分别进行血LAC、CHE和PA检测,并行APACHEⅡ评分,根据预后分为死亡组和治愈组,同时选取40例健康体检老年人为对照组,进行分析比较。结果:与健康组比较,老年重症肺炎患者入院第1天LAC明显增高,CHE及PA明显降低(P<0.01);死亡组第4天、第7天LAC明显高于治愈组,CHE及PA水平显著低于治愈组(均P<0.01)。血CHE及PA与APACHEⅡ评分呈负相关(r分别为-0.576及-0.389,均P<0.01);血LAC与APACHEⅡ评分呈正相关(r=0.665,P<0.01)。结论:联合动态监测血LAC、CHE及PA水平变化趋势有助于老年重症肺炎病情的监测及预后的判断。
Objective： To explore the significance of dynamic monitoring of serum levels of lactate（ LAC）,cholinesterase（ CHE） and prealbumin（ PA） in assessment of severity and prognosis of elderly patients with severe pneumonia. Methods： Serum levels of LAC,CHE,PA were determined at the 1,4 and 7thday of admission in 40 cases of elderly patients with severe pneumonia,and APACHE Ⅱ scores was evaluated. Patients were divided into death group and cured group according to the prognosis. Another 40 healthy elderly people were involved as the control group. Results： Compared with those of control group,serum level of（ LAC） increased,but levels of CHE and PA were decreased significantly at day of admission（ P 0. 01）. Serum level of LAC was significantly higher and levels of CHE and PA were significantly lower in death group than those of cured group at 4thand 7thdays after admission（ all P 0. 01）. Serum levels of CHE and PA were negatively correlated with APACHE Ⅱ scores（ r =- 0. 576 and- 0. 389,P 0. 01）,serum level of LAC was positively correlated with APACHE Ⅱ scores（ r = 0. 665,P 0. 01）. Conclusions： Combined and dynamic monitoring of the changes of serum LAC、CHE and PA helps to the monitoring and prognostic assessment for elderly patients with severe pneumonia.
出处
《内科急危重症杂志》
2015年第4期271-273,共3页
Journal of Critical Care In Internal Medicine
关键词
乳酸
胆碱酯酶
前白蛋白
重症肺炎
动态监测
Lactate Cholinesterase Prealbumin Severe pneumonia Dynamic monitoring
