老年重症肺炎患者动态监测乳酸、胆碱酯酶及降钙素原的临床意义.docVIP

老年重症肺炎患者动态监测血乳酸、胆碱酯酶及前白蛋白的临床意义 徐测梁 王齐国 新疆医科大学附属中医医院 乌鲁木齐 830000 【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APACHE Ⅱ评分，根据预后将40例老年重症肺炎患者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 老年重症肺炎患者与健康组比较，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、第7天LAC明显高于治愈组，P＜0.01,第4、第7天CHE及PA水平显著低于存活组，P＜0.01。血CHE及PA与APACHE Ⅱ评分呈负相关，r分别为-0.576及-0.389，P均＜；r=0.665，P ＜The clinical value of dynamic monitoring of serum lactate, cholinesterase and prealbumin in elderly patients with severe pneumonia Xu Ce-liang,Wang Qi-guo.Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Wulumuqi 830000,China 【Abstract 】Objective To evaluate dynamic monitoring of serum lactate(LAC), cholinesterase(CHE) and prealbumin(PA) levels in severity and prognosis assessment of elderly patients with severe pneumonia. Methods A total of 40 cases of elderly patients with severe pneumonia were enrolled in the study, 16 patients died (death group) and 24 cured (cure group) during the hospitalization. The serum lactate, cholinesterase and prealbumin levels were determined at the d1, d4 and d7 of admission and compared between two groups，and given APACHE Ⅱ scores on the first day. 40 health elderly people were detected as the control group. Results Elderly patients with severe pneumonia compared with control group,the lactate(LAC) were increased,but the cholinesterase(CHE) and prealbumin(PA) levels were significantly reduce of were hospitalized at d1(P＜0.01).The LAC levels in death group on d4 and d7 were significantly higher than those of cure group(P＜0.01).The CHE and PA levels in death group on d4 and d7 were significantly reduce than those in cure group (P＜0.01). The serum CHE levels and PA levels were significantly negatively correlated with APACHE II scores(r=-0.576 and -0.389，P0．01)，the serum LAC levels were significantly positively correlated with APACHE Ⅱ scores(r=0.665，P0．01)。 Conclusion Federal and dynamic monitoring of ser