摘要
目的:探讨肺炎感染诱发的老年多器官功能障碍(i-MODSE)患者感染指标、肿瘤坏死因子及血气指标的表达及意义。方法:根据急性生理与慢性健康Ⅱ(APACHEⅡ)评分将90例i-MODSE患者分为低危组(n=26,<20分)、中危组(n=28,20≤~<40分)及高危组(n=36,>40分),于入院时检测3组患者血浆降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)水平,测定3组患者外周血静动脉血二氧化碳分压差(Pcv-aCO2)、动脉血氧饱和度(SaO2)及乳酸(Lac)水平,比较3组患者治疗30 d时的死亡率。结果:入院时,3组患者血浆PCT、hs-CRP、TNF-α水平及外周血Pcv-aCO2、Lac水平比较,高危组>中危组>低危组,差异均有统计学意义(P<0.05);外周血SaO2水平比较,低危组>中危组>高危组,差异均有统计学意义(P<0.05);治疗30 d时的死亡率比较,高危组>中危组>低危组,差异具有统计学意义(P<0.01)。结论:PCT、hs-CRP、TNF-α、Pcv-aCO2、SaO2及Lac水平能够较好反映肺炎诱发i-MODSE患者的病情及预后。
Objective:To investigate the expression of infection index,tumor necrosis factor-αand blood gas analysis in infection-induced multiple organ dysfunction syndrome in the elderly(i-MODSE).Methods:90 patients with pneumonia-induced MODSE were selected as the study objects.Patients were grouped according to their APACHE II scores:the low risk group(n=26),the moderate risk group(n=28)and the high risk group(n=36).The procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),central venous-arterial carbon dioxide difference(Pcv-aCO2),oxygen saturation of blood(SaO2)and lactate(Lac)and mortality were compared and analyzed among the three groups.Results:The comparison of the levels of PCT,hs-CRP,TNF-α,Pcv-aCO2 and Lac among the 3 groups showed the high risk group>the moderate risk group>the low risk group,and the comparison of the levels of SaO2 showed low risk group>moderate risk group>high risk group,and the difference was statistically significant(P<0.05).The comparison of the mortality after 30 days'treatment showed the high risk group>the moderate risk group>the low risk group,and the difference was statistically significant(P<0.01).Conclusion:PCT,hs-CRP,TNF-α,Pcv-aCO2,SaO2 and Lac levels can be used to evaluate the condition and prognosis of the patients with i-MODSE.It can not only indicate the early intervention of pneumonia,but also the general pathogenesis of pneumonia-induced i-MODSE.
作者
徐国宾
戴娜
马建英
李正光
XU Guobin;DAI Na;MA Jianying;LI Zhengguang(Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Qingdao Hospital of Traditional Chinese Medicine,Qingda 0266033,Shandong,China)
出处
《贵州医科大学学报》
CAS
2020年第5期595-599,共5页
Journal of Guizhou Medical University
基金
山东省中医药科技发展计划项目(2015-353)
青岛市医药科研立项课题(2014-WJZD063)。
关键词
肿瘤坏死因子Α
肺炎
降钙素原
超敏C反应蛋白
静动脉血二氧化碳分压差
动脉血氧饱和度
乳酸
多器官功能障碍
tumor necrosis factor-α
pneumonia
procalcitonin
hypersensitive C-reactive protein
central venous-arterial carbon dioxide difference
oxygen saturation of blood
lactate
infection-induced multiple organ dysfunction syndrome in the elderly(i-MODSE)
