贵州医科大学学报

2020, v.45;No.236(05) 595-599

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老年肺炎诱发多器官功能障碍患者感染指标、肿瘤坏死因子及血气指标的表达及意义
Expression and Meaning of Infection Index,Tumor Necrosis Factor-α and Blood Gas Indexes in Pneumonia-induced Multiple Organ Dysfunction Syndrome in the Elderly

徐国宾;戴娜;马建英;李正光;
XU Guobin;DAI Na;MA Jianying;LI Zhengguang;Shandong University of Traditional Chinese Medicine;Qingdao Hospital of Traditional Chinese Medicine;

摘要(Abstract):

目的:探讨肺炎感染诱发的老年多器官功能障碍(i-MODSE)患者感染指标、肿瘤坏死因子及血气指标的表达及意义。方法:根据急性生理与慢性健康Ⅱ(APACHEⅡ)评分将90例i-MODSE患者分为低危组(n=26,<20分)、中危组(n=28,20≤~<40分)及高危组(n=36,> 40分),于入院时检测3组患者血浆降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)水平,测定3组患者外周血静动脉血二氧化碳分压差(Pcv-aCO2)、动脉血氧饱和度(Sa O2)及乳酸(Lac)水平,比较3组患者治疗30 d时的死亡率。结果:入院时,3组患者血浆PCT、hs-CRP、TNF-α水平及外周血Pcv-aCO2、Lac水平比较,高危组>中危组>低危组,差异均有统计学意义(P <0. 05);外周血Sa O2水平比较,低危组>中危组>高危组,差异均有统计学意义(P <0. 05);治疗30 d时的死亡率比较,高危组>中危组>低危组,差异具有统计学意义(P <0. 01)。结论:PCT、hs-CRP、TNF-α、Pcv-aCO2、Sa O2及Lac水平能够较好反映肺炎诱发i-MODSE患者的病情及预后。
Objective: To investigate the expression of infection index,tumor necrosis factor-α and blood gas analysis in infection-induced multiple organ dysfunction syndrome in the elderly( iMODSE). Methods: 90 patients with pneumonia-induced MODSE were selected as the study objects.Patients were grouped according to their APACHE II scores: the low risk group( n = 26),the moderate risk group( n = 28) and the high risk group( n = 36). The procalcitonin( PCT),hypersensitive C-reactive protein( hs-CRP),tumor necrosis factor-α( TNF-α),central venous-arterial carbon dioxide difference( Pcv-aCO2),oxygen saturation of blood( SaO2) and lactate( Lac) and mortality were compared and analyzed among the three groups. Results: The comparison of the levels of PCT,hs-CRP,TNF-α,Pcv-aCO2 and Lac among the 3 groups showed the high risk group > the moderate risk group > the low risk group,and the comparison of the levels of Sa O2 showed low risk group> moderate risk group > high risk group,and the difference was statistically significant( P < 0. 05). The comparison of the mortality after 30 days' treatment showed the high risk group > the moderate risk group> the low risk group,and the difference was statistically significant( P < 0. 01). Conclusion: PCT,hs-CRP,TNF-α,Pcv-aCO2,SaO2 and Lac levels can be used to evaluate the condition and prognosis of the patients with i-MODSE. It can not only indicate the early intervention of pneumonia,but also the general pathogenesis of pneumonia-induced i-MODSE.

关键词(KeyWords): 肿瘤坏死因子α;肺炎;降钙素原;超敏C反应蛋白;静动脉血二氧化碳分压差;动脉血氧饱和度;乳酸;多器官功能障碍
tumor necrosis factor-α;pneumonia;procalcitonin;hypersensitive C-reactive protein;central venous-arterial carbon dioxide difference;oxygen saturation of blood;lactate;infection-induced multiple organ dysfunction syndrome in the elderly(i-MODSE)

Abstract:

Keywords:

基金项目(Foundation): 山东省中医药科技发展计划项目(2015-353);; 青岛市医药科研立项课题(2014-WJZD063)

作者(Author): 徐国宾;戴娜;马建英;李正光;
XU Guobin;DAI Na;MA Jianying;LI Zhengguang;Shandong University of Traditional Chinese Medicine;Qingdao Hospital of Traditional Chinese Medicine;

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DOI: 10.19367/j.cnki.2096-8388.2020.05.017

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