血清淀粉样蛋白A在VAP患者中的临床价值

Value of serum amyloid A in predicting the prognosis of patients with ventilator-associated pneumonia

目的探讨血清淀粉样蛋白A(SAA)对预测呼吸机相关性肺炎(VAP)患者病情严重程度、疗效及预后的价值。方法选取34例VAP患者,根据治疗后转归情况分为恶化组(未愈/死亡组,A组)14例和康复组(治愈/存活组,B组)20例,分别于诊断为VAP第1、3、5d及死亡/转出ICU的当天,酶联免疫吸附法(ELISA)和免疫乳胶试验法检测血清SAA、CRP水平,并行急性生理学及慢性健康状况评分II(APACHEⅡ)。结果与B组比较,A组第1d、第3d、第5d及死亡/转出ICU的当天血清SAA、CRP及APACHEⅡ评分均明显增高(P均<0.01),B组血清SAA、CRP水平则随感染控制后明显下降;APACHEⅡ评分与血清SAA呈正相关(r=0.568,P<0.05)。结论血清SAA水平能反映VAP患者的病情严重程度、疗效及预后。

Objective To explore the value of serum amyloid A （SAA） in predicting the severity and prognosis of patients with v pneumonia（VAP）. Methods Among 34 patients with VAP were divided into two groups based on their prognosis including： the worsen group （ not cure/death group A, group ,n=14）and the recovery group （cure/survival group, group B,n =20）. The levels of serum SAA and CRP in all VAP patients were detected and given APACHE Ⅱ scores on the 1st, 3rd ,5th day of the rollment, and the last day before the patients died or were transferred. Results Compared with the B group, the levels of serums SAA and CRP in the group A significantly increased on the 1st,3rd ,5th day of the enrollment, and the last day before the patients died or wered transferred, and the levels of SAA,CRP and the APACHE II scores increased re- markably （P 〈 0. 01）. Serums SAA and CRP levels of group B decreased after infection controlled; Serum SAA levels was sig- nificantly correlated with APACHEⅡ scores （ respectively r =-0.568 ,P 〈 0. 05）. Conclusion The changes of serum SAA lev- els can reflect the severity of the disease in VAP patients and the prognosis.