蛋白质代谢水平与RICU老年下呼吸道感染患者近期预后的关系研究

Study on the Relationship between Protein Metabolism and Short-term Prognosis of Senile Patients with LRTI in RICU

目的探讨老年下呼吸道感染患者蛋白质代谢改变与近期预后的关系。方法测定139例RICU中老年下呼吸道感染患者入院时血清降钙素原(PCT)、前清蛋白(PA)、总蛋白(TP)、清蛋白(Alb)、血红蛋白(Hb)以及尿素氮(Bun)和肌酐(Cr)等反映蛋白质代谢水平的营养指标。根据PCT水平进行评分,将患者分为5组,进行各组间单因方差分析;并进行患者25d内死亡组和存活组间蛋白质代谢水平比较。结果不同PCT分值组间患者血清PA、Alb、Bun及Cr水平差异显著。PCT评分1、2、3及4分组PA水平显著低于0分组,有统计学意义;PCT评分3、4分组Alb水平显著低于0分组,有统计学意义;PCT 3、4分组Bun及ln Cr水平显著高于0分组,有统计学意义。25d内死亡组PA及Alb水平显著低于存活组,有统计学意义;25d内死亡组Bun水平显著高于存活组,有统计学意义。结论严重老年下呼吸道感染患者蛋白质代谢水平与感染及炎症的严重程度相关,与患者近期临床结局具有密切关系。

Objective To explore the relationship between the changes of protein metabolism and the short-term prognosis of the senile patients with lower respiratory tract infection （LRTI） in respiratory intensive care unit （RICU）. Methods PCT, PA, TP, Alb, Hb, Bun and Cr of 139 senile patients with LRTI were detected at admission for RICU and the patients were divided into 5 groups according to PCT scores; single factor analysis of variance was made among groups; protein metabolisms in death group and survival group within 25 days were compared. Results There existed a significant difference in PA, Alb, Bun and Cr among the groups with different PCT scores; PA in 1-, 2-, 3- and 4-mark group was obviously lower than that in 0-mark group, the difference was of statistical significance; Alb in 3- and 4-mark group was greatly lower than that in 0-mark group, the difference was of statistical significance; Bun and lnCr in 3-and 4-mark group were obviously higher than those in 0-mark group, the difference was of statistical significance; PA and Alb in death group within 25d were much lower than those in survival group, the difference was of statistical significance; Bun in death group within 25d was greatly higher than that in survival group, the difference was of statistical significance. Conclusions The protein metabolism of the senile patients with LRTI is correlated to the severity of infection and inflammation and is in close relationship with the short-term clinical outcome of the patients.