空腹血清前白蛋白水平与老年全身炎症反应综合征预后的关系

The relationship between fasting serum levels of prealbumin and the prognosis of SIRS in the elderly

目的探讨血清前白蛋白（PAB）水平与老年全身炎症反应综合征（SIRS）患者预后的关系。方法老年SIRS患者111例,于诊断SIRS当日行急性生理学慢性健康状况评分（APACHEII评分）,并于次日抽血测定空腹血清PAB水平;按患者APACHEII评分值将患者分为3组（A组10-16分,B组17-21分和C组≥22分）,分析3组患者血清PAB水平和预后;再根据疾病转归将患者分为生存组和死亡组,分析2组患者的空腹血清PAB水平和APACHEII评分值。结果3组患者死亡率比较有显著性差异（21.62%、62.16%、81.08%,P〈0.05）,A组空腹血清PAB水平〔（230.00±79.66）g/L）〕明显高于B、C组〔（160.44±61.40）g/L、（127.70±42.22）g/L,P〈0.05）〕,B组明显高于C组（P〈0.05）;死亡组APA-CHEII评分值较生存组高（24.52±8.00、16.65±4.11,P〈0.01）,空腹血清PAB水平较生存组低〔（156.21±73.95）g/L、（192.10±73.76）g/L,P〈0.01）〕。结论空腹血清PAB水平对评估老年SIRS患者的病情和预后具有一定的临床意义,其水平低者病情较重,死亡率较高。

Objective To explore the correlation between fasting serum levels of prealbumin （ PAB ） and the prognosis of systemic inflammatory response syndrome （SIRS） in the elderly. Methods The scores of acute pathologic and chronic health evaluation （APACHE） Ⅱ of Ⅲ elderly SIRS patients were calculated on the first day of diagnosing SIRS, and fasting venous blood samples were drawn on the next morning to detect the levels of PAB. Ⅲ patients were divided into group A （ APACHE Ⅱ 10-16）, group B （ APACHE Ⅱ 17-21 ） and group C （APACHE Ⅱ≥22 ） , to analyze the correlation between the serum levels of PAB and prognosis. Then the patients were divided into survival and death groups to analyze the serum levels of PAB and APACHE Ⅱ score. Results The mortality of three groups bad significant difference （21.62% vs 62.16% vs 81.08% ,P 〈 0.05 ） ,the serum levels of PAB was higher in group A （230.00 ± 79.66） g/L than that of group B （ 160.44 ±61.40） g/L and group C （ 127.70 ± 42.22） g/L （ P 〈 0. 05 ）, and that of group B was higher than that of group C （ P 〈 0. 05 ）. The APACHE Ⅱ score of death group （ 24. 52 ± 8.00 ） was higher than that of survival group （ 16.65 ± 4. 11 ） （ P 〈 0. 01 ）, and the serum levels of PAB of death group （ 156.21 ± 73.95 ） g/L was lower than that of survival group （ 192. 10 ± 73.76 ） g/L （ P 〈 0. 01 ）. Conclusions The serum levels of PAB has clinical significance in evaluating the prognosis of SIRS in elderly. The patients with lower serum levels of PAB has higher mortality.