C反应蛋白与血清乳酸判断老年患者危重急腹症感染预后的临床意义

Clinical value of C-reactive protein and serum lactate to the prognosis of acute abdomen in elderly patients

目的比较评估C反应蛋白(CRP)与血清乳酸(LAC)判断老年危重急腹症预后的临床意义。方法选择2013年6月至2014年5月在四川省人民医院进行手术的92例危重急腹症感染老年手术患者(试验组),并根据感染严重程度分为4个亚组:全身炎性反应综合征(SIRS)组、脓毒血症组、重度脓毒血症组、脓毒血症性休克组;另选取92名健康老年患者血清作为对照组。检测各组血清CRP与LAC水平,并对比LAC水平和CRP水平与预后良好及不良患者间的差异。结果与对照组比较,SISR组、脓毒血症组、重度脓毒血症组和脓毒血症性休克组CRP和LAC水平明显升高(均P<0.05);脓毒血症组、重度脓毒血症组和脓毒血症性休克组组间两两比较,LAC水平随着脓毒血症严重程度增加而升高(均P<0.05),而CRP水平差异无统计学意义(P>0.05);试验组中,预后不良组血清CRP和LAC浓度明显比预后良好组高(P<0.05)。结论老年危重急腹症感染患者血清CRP与LAC对感染预后的预测均具有重要参考意义,CRP水平对急腹症感染早期(6h)轻度时有较好的预测性,而LAC对急腹症感染程度较严重时有较好的预测性。

Objective To compare the clinical value of CRP and LAC in the evaluating of diagnosis and the prognosis of se‐vere acute abdomen diseases in the elderly patients .Methods Experimental group：The blood of 92 elderly patients diagnosed with critical abdomen mass with infection and followed by surgery were collected .Then ,extracted serum was used to measure the levels of CRP and LAC ,and these patients were divided into 4 groups on base of the degree of infection：SIRS group ,sepsis group ,serve sepsis group and septic shock group .Control group：92 serums of healthy persons were selected to measure the levels of CRP and LAC .Results The CRP and LAC significantly increased in the experimental group ,when compared with the control group（P〈0 .05） .The level of LAC raised with the increase severity of sepsis（P〈0 .05） among groups of sepsis ,serve sepsis and sepsis with shock ,but the level of CRP had no statistical difference（P〉0 .05） .Conclusion Both CRP and LAC of elderly patients diagnosed with critical abdomen mass with infection have important referential meaning .Furthermore ,the CRP has better predictability in the early stage of abdomen mass with infection .However ,to predict the severity of infection level ,LAC seems more sensitive .