老年重症肺炎血清胆碱酯酶、前白蛋白与预后

Relationship between prognosis and the changes of serum cholinesterase and pre-albumin in the elderly patients with serious pneumonia

目的了解老年重症肺炎血清胆碱酯酶(CHE)、前白蛋白(PA)变化特点及临床意义。方法 47例老年重症肺炎患者,治疗后按转归分为治愈/存活组(A组)24例和未愈/死亡组(B组)23例,均于入组当天检测血清CHE、PA、CRP,并行APACHEⅡ评分;于入组第3天检测血清CHE、PA。20例健康老年人为对照组(C组)。结果与A组比较,B组第1天及第3天血清CHE、PA均明显降低(P均<0.01);CRP及APACHEⅡ评分均明显增高(P均<0.01)。两组与C组比较,血清CHE、PA均明显降低(P均<0.01)。APACHEⅡ评分与血清CHE及PA呈负相关,r分别为-0.568及-0.399(P均<0.01)。结论血清CHE、PA的变化能反映老年重症肺炎病情严重程度及预后。

Objective To explore the change characteristics of the serum cholinesterase （CHE） and pre-albumin （PA） in the elderly patients with severe pneumonia and their clinical significances. Methods 47 elderly patients with severe pneumonia were divided into two groups based on their prognosis ： the survival group （ n = 24） and the death group （ n = 23 ）. For all of the patients, their serum CHE, PA, and CRP were detected and given APACHE U score on the frist day. And on the third day, the serum CHE and PA were de- tected again. Besides, the levels of the serum CHE, PA and CRP in 20 healthy elderly people, as the control group, were detected. Re- suits Compared with the survival group, the levels of serums CHE and PA in the death group decreased obviously and the levels of CRP and the APACHE II scores increased remarkably （P 〈0. O1 ）. While compared with the control group, the levels of serums CHE and PA of the above two groups both decreased remarkably （P 〈0.01 ）. In patients with serious pneumonia the serum CHE and PA levels were both significantly negatively correlated with APACHE U scores （ respectivelyr = - 0. 568 and - 0. 399, P 〈 0.01 ）. Conclusion The changes of serum CHE and PA can reflect the severity of the patients＇ conditions and their prognosis.