术后重症患者白蛋白及胆碱酯酶水平的变化及其临床意义

Level and clinical significance about albumin and cholinesterase of critical patients after surgery

目的探讨术后重症患者白蛋白及胆碱酯酶(ChE)水平的相关性与临床意义。方法检测176例术后重症患者及158例健康体检者的白蛋白及胆碱酯酶水平,进行比较及相关性分析。将176例患者按照APACHEⅡ评分分成3组(<15分组、≥15～20分组、>20分组),比较3组间血清白蛋白、胆碱酯酶检测值及病死率的差异。结果①术后重症患者的白蛋白及胆碱酯酶水平较健康体检者明显降低(P<0.01)。术后重症患者的白蛋白及胆碱酯酶水平呈显著正相关(r=0.907,P<0.01);②>20分组白蛋白和胆碱酯酶水平高于15～20分组及<15分组,差异有统计学意义(P<0.01);APACHEⅡ评分分值越高,白蛋白和胆碱酯酶水平越低,死亡率越高(P<0.01)。结论白蛋白及胆碱酯酶水平与患者病情危重程度有关,结合APACHEⅡ评分判断术后重症患者病情及预后。

Objective To study the relationships and clinical significance of critical patients after the surgery between albumin and cholinesterase.Methods The study included checking out,comparing and relativity analyzing the levels of albumin and cholinesterase in 176 critical patients after the surgery and 158 normal people.176 patients were divided into three groups according to APACHE Ⅱ score（15 scores,≥15-20 scores,20 scores）.Albumin,cholinesterase and death rate were compared to find their differences between three scores groups.Results ①The levels of albumin and cholinesterase in critical patients after the surgery were markedly lower than those in normal people（P0.01）.The two indexes presented remarkable positive correlation（r=0.907,P0.01）;② The levels of albumin and cholinesterase in 20 scores group were higher than the other two scores groups.The differences between them had statistic significance（P0.01）;the higher APACHE Ⅱscore,the lower the levels became and the higher mortality rate（P0.01）.Conclusion The levels of albumin and cholinesterase are related to the extent of critical patients＇ condition.Besides,the estimation and the prognosis should combine with APACHE Ⅱ score.