血清前白蛋白对老年慢性阻塞性肺疾病急性发作期病情严重程度及预后的评估价值

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

目的探讨老年慢性阻塞性肺疾病(COPD)患者血清前白蛋白(PAB)与病情严重程度及预后的关系。方法选取入院治疗的65岁以上老年慢性阻塞性肺疾病急性加重期(AECOPD)患者100例,按患者简化急性生理学评分Ⅱ(SAPSⅡ)评分值将患者分为A组31例(SAPSⅡ20～30分)、B组40例(SAPSⅡ30～40分)和C组29例(SAPSⅡ>40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,分析两组患者空腹血清PAB水平和SPASⅡ评分值。结果3组患者病死率(0%、5%、34%)比较,差异有显著性意义(P<0.05),A组空腹血清PAB水平[(200.05±64.49)mg/l)]明显高于B、C组[(173.79±42.47)mg/l、(140.55±30.18)mg/l](P<0.05),B组明显高于C组(P<0.05);死亡组SAPSⅡ评分值较生存组高[(44.42±2.71)分vs(32.75±6.43)分,P<0.05],空腹血清PAB水平较生存组低[(137.36±26.43)mg/lvs(177.05±53.55)mg/l,P<0.05]。结论空腹血清PAB水平对评估老年AECOPD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,病死率较高。

Objective To explore the correlation between fasting serum levels of prealbumin（PAB）and the prognosis of acute exacerbation of Chronic Obstructive Pulmonary Disease （AECOPD）in the elderly.Methods Simplified acute physiology score （SAPS）Ⅱ 0f 100 elderly AECOPD patients were calculated on the first day of diagnosing AECOPD and fasting venous blood samples were drawn on the next morning to detect the levels of PAB. l00 patients were divided into group A（SAPS Ⅱ 20-30）,group B（SAPS Ⅱ 30 -40）and group C （SAPS Ⅱ≥40）. The correlation between the serum levels of PAB and prognosis was analyzed.Then the patients were divided into survival group and death group？ according to the prognosis. The serum levels of PAB and SAPS Ⅱ score were compared between these two groups ,too.Results The mortality rate of the three groups had significant difference （0% vs 5% vs 34%,P 0.01）,the serum levels of PAB was higher in group A（（200.05±64.49） mg/l than that of group B（173.79±42.47） mg/l and group C（127.70±42.22） mg/l （P 0.05）,while the serum levels of PAB in group B was higher than that of group C（P 0.05）.The SAPS 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） mg/l was lower than that of survival group（192.10±73.76） mg/l （P 0.01）.Conclusions The serum levels of PAB has clinical significance in evaluating the prognosis of AECOPD in elderly.The patients with lower serum levels of PAB has higher mortality rate.