C-反应蛋白及血清白蛋白在老年吸入性肺炎患者预后判断中的意义

Significance of CRP and ALB in prognosis diagnosing of elderly aspiration pneumonia

目的探讨C反应蛋白(CRP)及血清白蛋白(ALB)指标变化在老年吸入性肺炎患者预后判断中的意义。方法收集我院呼吸内科重症监护室120例老年吸入性肺炎患者临床资料,根据患者临床预后分为死亡组及存活组,比较两组患者CRP及ALB指标变化在临床预后判断中的价值。结果 120例患者中,死亡26例,存活94例。死亡组与存活组患者的CRP及ALB在治疗前比较差异无统计学意义(P>0.05)。存活组CRP治疗后有2例较治疗前升高,其余均降低;死亡组均升高。存活组ALB治疗后有5例较治疗前下降,其余均升高;死亡组均降低。两组治疗后CRP及ALB比较差异有显著统计学意义(P<0.01)。两组治疗前后CRP指标组内比较差异有显著统计学意义(P<0.01),死亡组ALB治疗前后比较差异有显著统计学意义(P<0.01)。治疗后CRP降低患者的存活率(92/92,100%)明显高于CRP升高患者的存活率(2/28,7.14%,P<0.01);治疗后ALB升高患者的存活率(89/89,100%)明显高于ALB降低患者的存活率(5/31,16.13%)。结论动态监测CRP及ALB指标的变化对判断老年吸入性肺炎患者的预后具有较为重要的指导意义。

Objective To discuss the role of C-reactive protein（CRP） and serum albumin（ALB） in prognosis diagnosing of elderly patients with aspiration pneumonia. Methods The data of 120 cases of elderly aspiration pneumonia patients admitted in the department of respiratory intensive care unit of our hospital were collected and analyzed.According to the clinical prognosis the patients were divided into death and survival groups.The effects of CRP and ALB changes on the clinical prognosis were compared. Results Total 120 cases of elderly aspiration pneumonia,26 cases died,94 cases survived.The differences of CRP and ALB between the death group and survival group before treatm-ent showed no statistical significance（P0.05）.The CRP values after treatment in 2 cases were higher than before treatment in survival group,the rest decreased.whereas in the death group,CRP in all cases increased after treatment.The ALB values after treatment of 5 cases were lower than before treatment in survival group,the rest increased.whereas in the death group,ALB in all cases decreased after treatment.There were significant difference in CRP and ALB level after treatment and when compared with CRP level before and after treatment between the two groups（P0.01）.There were significant difference in ALB level before and after treatment in the death group（P0.01）.The survival rate of patients with decreased CRP level after treatment（92/92,100%） was significantly higher than the patients with increased CRP level（2/28,7.14%）（P0.01）.The survival rate of patients with increased ALB level after treatment（89/89,100%） was significantly higher than the patients with decreased ALB level（5/31,16.13%）（P0.01）. Conclusion Dynamic observation of CRP and ALB level has important guiding significance in determining the clinical prognosis of elderly aspiration pneumonia.