柳立岩,王春,张雪云
LIU Liyan,WANG Chun,ZHANG Xueyun

• 1:辽宁省人民医院呼吸内科

摘要(Abstract)：

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)及纤维蛋白原(Fib)检测在脑卒中相关性肺炎(SAP)中的临床意义。方法:317例SAP患者,按照肺炎严重指数(PSI)分为低危组(PSI为Ⅰ~Ⅲ级)及中高危组(PSI为Ⅳ、Ⅴ级),按血气分析结果分为呼吸衰竭组及无呼吸衰竭组,按出院时疾病治疗结局分为存活组及死亡组;SAP患者于入院4 h内分别采用双抗体夹心电化学发光法、免疫比浊法及凝固法测定血清降钙素原(PCT)、C反应蛋白(CRP)及纤维蛋白原(Fib)水平,采用Logistic回归分析PSI分级与患者血清PCT、CRP及Fib的相关性,分析SAP患者血清PCT、CRP及Fib含量在中高危组与低危组间、呼吸衰竭组与无呼吸衰竭组间及生存组与死亡组间的差异。结果:SAP患者血清PCT、CRP及Fib水平在不同标准分组的各组间比较,中高危组高于低危组,呼吸衰竭组高于无呼吸衰竭组,死亡组高于存活组,差异有统计学意义(P<0.05);SAP患者血清PCT、CRP及Fib水平与PSI有相关性(r=0.778、0.798、0.537,P<0.05)。结论:SAP患者血清PCT、CRP及Fib水平与入院4 h内病情严重程度呈正相关,可作为SAP评判预后的指标。
Objective: To explore the clinical significance of serum PCT,CRP and Fib in stroke-associated pneumonia( SAP). Method: 317 patients with SAP were divided into low risk group( PSI IIII) and high risk group( PSI IV and V) in terms of pneumonia severity index( PSI),respiratory failure group and non respiratory failure group in terms of blood gas analysis,survival group and death group in terms of disease treatment outcome at discharge. Within 4h of patients' being admitted to hospital,double antibody sandwich electrochemiluminescence method,immunoturbidimetry and coagulation method were adopted to detect serum level of procalcitonin( PCT),C reactive protein( CRP) and fibrinogen( FIB). Logistic regression analysis was adopted to analyze the correlation between PSI classification and serum level of PCT,CRP and FIB. The differences in serum levels of PCT,CRP and FIB were analyzed in each groups. Result: The serum levels of PCT,CRP and Fib in high risk group were higher than those in low risk group,were higher in respiratory failure group than those in non respiratory failure group,and higher in death group than those in survival group. The difference was statistically significant( P < 0. 05). The serum levels of PCT,CRP and FIB were correlated with PSI in patients with SAP( r = 0. 778,0. 798,0. 537,P < 0. 05). Conclusion: There is positive correlation between serum PCT,CRP and Fib and the patient's severity within 4 h of being admitted to hospital,which can be prognosis indexes of SAP.

关键词(KeyWords)： 降钙素原;C反应蛋白;纤维蛋白原;呼吸衰竭;卒中相关性肺炎
procalcitonin;C reactive protein;fibrinogen;respiratory failure;stroke-associated pneumonia

Abstract:

Keywords:

基金项目(Foundation): 辽宁省科技计划项目(2010225036)

作者(Author): 柳立岩,王春,张雪云
LIU Liyan,WANG Chun,ZHANG Xueyun

DOI: 10.19367/j.cnki.1000-2707.2016.07.020

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