血清前白蛋白变化在医院获得性肺炎中的临床意义

Clinical significance of serum PAB changes in hospital-acquired pneumonia

目的：探讨医院获得性肺炎（hospital-acquired pneumonia,HAP）患者血清前白蛋白（prealbumin,PAB）变化的临床意义。方法：选取入院治疗的HAP患者75例,按简化急性生理学评分Ⅱ（SAPS Ⅱ）评分值将患者分为A组25例（20~30分）、B组25例（SAPS Ⅱ30~40分）和C组25例（SAPS II〉40分）,分析3组患者血清PAB,总蛋白（TP）和白蛋白（ALB）水平及预后;两周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,TP,ALB水平和SPAS Ⅱ评分值。结果：3组患者比较,A组空腹血清PAB水平明显高于B、C组;B组明显高于C组（P〈0.05）,而TP,ALB无统计学意义;死亡组SAPS Ⅱ评分值较生存组高,空腹血清PAB水平较生存组低,而TP,ALB无统计学意义。结论：空腹血清PAB水平可作为评估HAP患者炎症控制的敏感性指标,对评估病情和预后具有一定的临床意义。

Objective：To explore the clinical significance of changes of serum prealbumin（PAB） in hospital-acquired pneumonia（HAP）.Methods：75 patients with HAP were selected and evenly divided into 3 groups according to the simplified acute physiology score（SAPS）Ⅱ,group A（SAPSⅡ scores 20-30）,group B（SAPSⅡ scores 30-40） and group C（SAPSⅡ scores40）,25 cases in each group.The serum levels of PAB,total protein（TP） and albumin（ALB）,and prognosis were analyzed among 3 groups.After 2 weeks,the patients were redivided into survival group and death group according to prognosis.Fasting serum levels of PAB,TP and ALB and SAPSⅡ scores were compared between two groups.Results：Comparing 3 groups,fasting serum level of PAB in group A was obviously higher than that of group B and C.Group B was higher than group C（P0.05）.But the changes of TP and ALB had no statistical significance.The SAPSⅡ scores of the death group were higher than those of the survival group.The fasting serum level of PAB of the death group was lower than that of the survival group.But the changes of TP and ALB showed no statistical significance.Conclusion：Fasting serum level of PAB may be used as a sensitive index in evaluating inflammation control of HAP,which has some clinical significance in estimating the disease condition and prognosis.