机械通气对重症肺炎患者尿微量白蛋白水平的影响

Changes of microalbunminuria （MAU） levels in mechanical ventilated patients with severe pneumonia and the clinical significance on prognosis of these patients.

目的探讨机械通气对重症肺炎患者尿微量白蛋白水平的影响。方法采用机械通气治疗的78例重症肺炎患者，治疗72h内动态检测尿微量白蛋白（MAU）与尿肌酐（CR）比值（ACR）MAU／CR，以ACR值25mg／mmol为临界值，分为ACR增多组与未增多组，观察两组MAU水平的动态变化，以评估与预后的关系。结果重症肺炎78例中，入院72h MUA水平增高64例（占82．1％），其中ACR增高组46例，ACR未增高组18例。两组APACHEH评分、CPIS评分、降钙素原、2周内脱机成功率和病死率比较差异均有统计学意义（t=3．50、2．19、χ^2=3．95、6．70、5．38，P=0．01，0．03，0．04，0．01，0．02，均P〈0．05）。结论机械通气治疗重症肺炎患者MAU水平检测对评估预后有重要的临床意义。

Objective To evaluate the clinical significance of the changes of microalbunmlnurla（MAU） levels in mechanical ventilated patients with severe pneumonia. Methods According to the ratio between the mieroalbunminuria and the urine creatinine （MAU/CR） （ACR） , setting 25mg/mmol as the threshold,78 mechanleal ventilated patients with severe pneumonia were divided into two groups：ACR increasing group and ACR Non-increasing group ,then the clinical significance of changes of MAU levels in 72 hours on prognosis of these patients was observed. Results MAU increased in 64 cases（82. 1% ） ,of which 46 cases in ACR increasing group and 18 eases in ACR non-increasing group. There showed statistically significant differences on APACHE Ⅱ score, CPIS score, PCT, the success of getting out of mechanical ventilation and the mortality between two groups, （ t = 3.50,2. 19 ,χ^2 = 3.95, 6. 70,5.38, P = 0. 01,0. 03,0. 04,0. 01,0. 02, all P 〈 0. 05 ）. Conclusion Changes of MAU levels have the elinieal significance on prognosis of the mechanical ventilated patients with severe pneumonia.