肺炎患者血清胆碱酯酶变化的意义与炎性指标间的关系

Significance of change of serum cholinesterase for patients with pneumonia and its correlation with inflammatory markers

目的探讨肺炎患者血清胆碱酯酶的变化及与炎性指标间的关系,以期发现新的炎性指标,并为该疾病的诊治与病情监测提供依据。方法以2009年3月-2012年3月在医院住院确诊的93例肺炎患者为肺炎组,随机抽取同期健康体检者60名为对照组,应用丁酰硫代胆碱法分别测定肺炎组和对照组患者血清胆碱酯酶水平,同时检测血常规、C-反应蛋白等炎症指标,分析血清胆碱酯酶与肺炎常规检测指标的相关性,留取痰液标本进行细菌学培养及鉴定。结果 93例肺炎患者检出病原菌以铜绿假单胞菌为主占45.31%;肺炎组与对照组比较,肺炎患者血清胆碱酯酶水平显著降低,差异有统计学意义(P<0.05);而C-反应蛋白、中性粒细胞、白细胞计数明显升高(P<0.05);Pearson直线相关分析显示,肺炎患者血清胆碱酯酶水平与C-反应蛋白、中性粒细胞及白细胞总数呈显著负相关(r值分别为-0.693,-0.451,-0.534,P<0.05)。结论肺炎患者血清胆碱酯酶水平明显降低,其机制可能与参与炎症反应有关,在临床实践中血清胆碱酯酶可作为病情监测和治疗的生物标志物。

OBJECTIVE To explore the change of serum cholinesterase in the patients with pneumonia and observe its correlation with the inflammatory markers so as to find new inflammatory markers and provide guidance for di-agnosis and treatment of the disease as well as the surveillance of illness condition .METHODS A total of 93 pa-tients with confirmed pneumonia ,who were hospitalized from Mar 2009 to Mar 2012 ,were recruited as the pneu-monia group ,meanwhile ,60 healthy people who underwent physical examination were randomly selected as the control group;the level of serum cholinesterase of the pneumonia group and the control group was respectively de-termined by using S-Butyrylthiocholine iodide method ,the inflammatory markers such as the blood routine and C-reactive protein were detected ,the correlation between the level of serum cholinesterase and the indicators for pneumonia routine examination was analyzed ,and the sputum specimens were sampled for bacteriological culture and identification .RESULTS The Pseudomonas aeruginosa was dominant among the pathogens isolated from the 93 patients with pneumonia ,accounting for 45 .31% .As compared with the control group ,the level of serum cho-linesterase of the pneumonia group was significantly reduced ,there was statistically significant difference （P〈0 .05）;however ,the level of C-reactive protein ,neutrophils ,and white blood cells counts were remarkably elevat-ed （P〈0 .05） .Pearson linear correlation analysis indicated that the level of serum cholinesterase of the patients with pneumonia was negatively correlated with the level of C-reactive protein ,neutrophils ,and total counts of white blood cells ,with the r values of -0 .693 ,-0 .451 ,and -0 .534 ,respectively （P〈 0 .05） .CONCLUSION The level of serum cholinesterase of the patients with pneumonia is significantly reduced ,the mechanism may be associated with its involving inflammatory reaction ,and the serum cholinesterase can be served as the biological marker for surveillance of illness condition and treatment in the clinical practice .