BNP、CRP、WBC、Lp(a)、ChE在老年肺部感染中的水平及其意义

Level and significance of BNP,CRP,WBC,Lp(a)and ChE inelderly patients with pulmonary infection

目的探讨B型脑钠肽(BNP)、C反应蛋白(CRP)、白细胞计数(WBC)、脂蛋白a[(Lp(a)]、胆碱酯酶(ChE)在老年肺部感染患者中的水平及意义。方法选取2010年1月-2017年12月南京大学医学院附属鼓楼医院老年肺部感染患者79例,根据肺炎严重程度指数(PSI),Ⅰ级患者21例,Ⅱ、Ⅲ级患者35例,Ⅳ、Ⅴ级患者23例。检测患者BNP、CRP、WBC、Lp(a)和ChE水平。结果Ⅳ、Ⅴ级患者BNP、CRP、WBC和Lp(a)高于Ⅰ级和Ⅱ、Ⅲ级患者(P<0.05),而ChE低于Ⅰ级和Ⅱ、Ⅲ级患者(P<0.05);Ⅱ、Ⅲ级患者BNP、CRP、WBC和Lp(a)分别高于Ⅰ级患者(P<0.05),而ChE低于Ⅰ级患者(P<0.05);死亡患者的PSI评分、BNP、CRP、WBC和Lp(a)分别高于存活患者(P<0.05),而ChE低于存活患者(P<0.05);BNP、CRP、WBC、Lp(a)与PSI评分呈正相关(r=0.433、0.410、0.382和0.390,均P<0.05),而ChE与PSI评分呈负相关(r=-0.421,P<0.05)。结论BNP、CRP、WBC、Lp(a)和ChE水平与老年肺部感染患者病情程度、预后有一定关系,对临床救治判断有一定指导作用。

Objective To investigate the level and significance of B type natriuretic peptide(BNP),C reactive protein(CRP),white blood cell count(WBC),Lipoprotein a(Lp(a),cholinesterase(ChE)in the elderly patients with pulmonary infection.Methods From January 2010 to December 2017,79 elderly patients with pulmonary infection were treated in our hospital,according to the severity index of pneumonia(PSI).There were 21 patients in grade I,35 in grade II to III,and 23 in grade IV to V.The levels of BNP,CRP,WBC,Lp(a)and ChE were detected in the patients.Results BNP,CRP,WBC and LP(a)were higher in grade IV and V patients than in grade I,II and III patients(P<0.05),while ChE was lower in grade I,II and III patients(P<0.05);BNP,CRP,WBC and LP(a)were higher in grade II and III patients than in grade I patients(P<0.05),while ChE was lower in grade I patients(P<0.05).The scores of PSI,BNP,CRP,WBC and LP(a)in dead patients were higher than those in alive patients(P<0.05),while ChE was lower than that in alive patients(P<0.05).BNP,CRP,WBC and LP(a)were positively correlated with the scores of PSI(r=0.433,0.410,0.382 and 0.390,all P<0.05),while ChE was negatively correlated with the scores of PSI (r = -0.421, P < 0.05). Conclusion The levels of BNP, CRP, WBC, Lp (a) and ChE have a certain relationshipwith the severity and prognosis of the elderly patients with pulmonary infection, and have a certain guiding rolein the judgment of clinical treatment.