血生化指标对老年患者肺部感染预后的评价

Correlation between blood nutritional indicators and pulmonary infections in elderly patients and its effect on the prognosis

目的探讨老年肺部感染患者血生化指标水平变化及在预后中的评价作用,以期为该病的早期诊治及营养支持提供依据。方法选取2011年6月-2012年6月住院的100例老年肺部感染患者为感染组,取同期健康体检老年患者40名为对照组;根据预后分为生存组71例和死亡组29例;分别测定各组血白蛋白(ALB)、总蛋白(TP)、前白蛋白(PA)及血红蛋白(Hb)含量和淋巴细胞计数(Tlc)。结果与对照组比较,ALB、PA、TP、Hb及Tlc低于正常值比例显著增高(P<0.05),各项指标水平明显下降(P<0.05);老年肺部感染患者血ALB、PA、TP和Hb水平随年龄增长呈现下降的趋势(P<0.05),而Tlc在各年龄段无明显差异;与生存组比较,死亡组患者ALB、PA、TP、Hb及Tlc低于正常值比例显著增高,各项指标水平明显下降(P<0.05)。结论肺部感染易导致老年患者营养不良发生;ALB、PA、TP、Hb及Tlc联合监测对患者病情监测及预后具有评价作用。

OBJECTIVE To investigate the change of levels of serum nutritional indicators and explore the predictive value in evaluation of prognosis of the elderly patients with pulmonary infections so as to provide the evidence for early diagnosis and nutritional support.METHODS A total of 100cases of hospitalized elderly patients with pulmonary infections between Jun 2011and Jun 2012were enrolled in this study,while 40healthy elderly people were selected randomly as the control group during the same period,then the serum albumin（ALB）,total protein（TP）,prealbumin（PA）,peripheral blood red protein（Hb）,and lymphocyte count（Tlc）were measured for the above-mentioned patients.RESULTS Compared with the control group,the abnormal rate of ALB,PA,TP,Hb and Tlc increased significantly with each nutritional indicator level decreased（P〈0.05）;The levels of ALB,PA,TP and Hb were inclined to decrease as the age of the elderly patients with pulmonary infections increased（P 0.05）,but there was no significant difference in Tlc between the various age groups;the blood PA,ALB,TP,Hb and Tlc of the death group was dramatically decreased compared with the survival group,and the abnormal rate of blood nutritional indicators in the death group was comparatively higher than that of the survival group（P〈0.05）.CONCLUSION The pulmonary infections can easily lead to the occurrence of malnutrition in the elderly patients;the joint monitoring of ALB,PA,TP,Hb,and Tlc has great value to the patient＇s condition and prognosis.