血清C反应蛋白水平对急性肺栓塞患者病情严重程度和预后的评估价值

Estimated Value of Serum CRP Level on Severity of Illness and Prognosis of Patients With Acute Pulmonary Embolism

目的探究血清C反应蛋白(CRP)水平对急性肺栓塞患者病情严重程度和预后的评估价值。方法选取内蒙古自治区人民医院呼吸内科2012年1月—2015年1月收治的急性肺栓塞患者58例,根据血清CRP水平分为A组26例(CRP≥10 mg/L)和B组32例(CRP<10 mg/L)。回顾性分析两组患者的生命体征(包括收缩压、舒张压、心率和呼吸频率)、疾病危险程度分层(分为低危、中危和高危)、并发症发生情况〔包括右心室功能不全、低血压、动脉血氧分压(Pa O2)<60 mm Hg、心肌损伤和心源性休克〕和预后(包括入住ICU和住院期间死亡)。结果A组患者收缩压和舒张压低于B组,心率和呼吸频率高于B组(P<0.05)。A组患者疾病危险程度分层劣于B组(u=3.024,P=0.003)。A组患者右心室功能不全、低血压、心肌损伤发生率高于B组(P<0.05);两组患者Pa O2<60mm Hg发生率及心源性休克发生率比较,差异无统计学意义(P>0.05)。A组患者入住ICU率高于B组(P<0.05);两组患者住院期间病死率比较,差异无统计学意义(P>0.05)。结论血清CRP水平能有效评估急性肺栓塞患者病情严重程度和预后,血清CRP≥10 mg/L常提示急性肺栓塞患者心功能损伤严重、微循环血流灌注不足,且会增加入住ICU的概率。

Objective To analyze the estimated value of serum CRP level on severity of illness and prognosis of patients with acute pulmonary embolism. Methods From January 2012 to January 2015, a total of 58 patients with acute pulmonary embolism were selected in the Department of Respiratory Medicine,People＇ s Hospital of Inner Mongolia,and they were divided into A group（ with serum CRP level equal or over 10 mg / L,n = 26） and B group（ with serum CRP level less than10 mg / L,n = 32） according to serum CRP level. Vital signs（ including SBP,SDP,heart rate and respiratory rate）,disease risk stratification（ including low- risk, moderate- risk and high- risk）, incidence of complications（ including right ventricular dysfunction,hypotension, Pa O2 less than 60 mm Hg, myocardial injury and cardiogenic shock） and prognosis（ transferred into ICU and died during hospitalization） were retrospectively analyzed. Results SBP and SDP of A group were statistically significantly lower than those of B group,while heart rate and respiratory rate of A group were statistically significantly higher than those of B group（ P〈0. 05）. The disease risk stratification of A group was statistically significantly worse than that of B group（ u = 3. 024,P = 0. 003）. The incidence of right ventricular dysfunction,hypotension and myocardial injury of A group was statistically significantly higher than that of B group, respectively（ P〈0. 05）, while no statistically significant differences of incidence of Pa O2 less than 60 mm Hg or cardiogenic shock was found between the two groups（ P〉0. 05）. The rate of transferred into ICU of A group was statistically significantly higher than that of B group（ P〈0. 05）,while no statistically significant differences of fatality rate during hospitalization was found between the two groups（ P〈0. 05）. Conclusion Serum CRP level can effectively estimate the severity of illness and prognosis of patients with acute pulmonary embolism, acute pulmonary embolism patients with serum CRP level equal or over 10 mg / L have severer cardiac function injury, worse microcirculation perfusion and high risk of transfer into ICU.