低蛋白血症对呼吸机相关性肺炎预后的影响

Effect of hypoproteinemia on prognosis of patients with ventilator-associated pneumonia

目的:研究呼吸机相关性肺炎(VAP)患者血清白蛋白水平对VAP患者预后的影响。方法:在确诊为VAP的第3天测定血清白蛋白并进行急性生理学及慢性健康状况评分(APACHE),分为:1正常白蛋白组及低蛋白血症组:统计两组APACHE评分值、多器官功能障碍综合征(MODS)发生率、脱机时间及病死率;2存活组及死亡组:统计两组血清白蛋白水平变化。结果:正常白蛋白组及低蛋白血症组APACHE评分值、MODS发生率、脱机时间及病死率比较均有显著性差异(P<0.05);存活组及死亡组血清白蛋白低于正常值的标本数及血清白蛋白水平均有显著性差异(P<0.05)。结论:血清白蛋白浓度与VAP患者病情严重程度和病死率有密切关系,可作为判断VAP预后简易可靠的指标之一,低蛋白血症常提示预后不良。

Objective： To study the serum albumin level in the patients winh ventilator-associated pneumonia and the relationship between the serum albumin level and the prognosis . Methods ： 108 cases in our ICU who suffered from VAP were enrolled in the study. Acute physiology and chronic health evaluation II （APACHEII） scores and the serum albumin were monitored 3 days after diagnosised as VAP. All cases were divided into ：① the normal albumin group and the hypoproteinemia group： analysed the APACHEII scores, the time of weaning from ventilator and the rate of the multiple organ dysfunction syndrome （MODS） and death. ② The survived and non- survived group ： analysed the serum albumin level. Results ： The APACHEII scores , the time of weaning from ventilator and the rate of MODS and death of the normal albumin group and the hypoproteinemia group were significantly different （P〈 0. 05）. The hypoproteinemia cases and the serum albumin level of the survived and non- survived groups were significantly different （P〈0.05）. Conclusion： The serum albumin level can reflect the state and prognosis of the VAP patients sensitively and can be used as one of the simple and reliable indexes for judging the outcome.