摘要
目的探讨肌红蛋白(Mb)对重症肺炎严重程度及预后的预测价值。方法选取45例重症肺炎患者为重症组,40例普通肺炎患者为普通组。入院后均给予集束化治疗,治疗前评估急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)及序贯器官衰竭评分(SOFA)评分,静脉采血检测血清Mb、心肌肌钙蛋白Ⅰ(cTnⅠ)、降钙素原(PCT)、C反应蛋白(CRP)水平,动脉采血测定血清乳酸水平,评价Mb与上述指标的关系;根据预后情况将重症组分为死亡组与存活组,比较两组Mb动态监测水平。结果与普通组相比,重症组APACHEⅡ、SOFA评分及血清Mb、cTnⅠ、PCT、CRP、乳酸水平升高(P<0.05)。重症组Mb与APACHEⅡ、SOFA评分、血清PCT、CRP、乳酸、cTnⅠ呈正相关(P<0.05)。重症组住院期间死亡率高于普通组(P<0.05)。死亡组入院后血清Mb浓度持续升高,存活组血Mb浓度中度升高后维持稳定,48 h后逐渐下降;死亡组入院后各时间点血清Mb浓度均高于存活组(P<0.05)。结论 Mb与重症肺炎常见的临床实验指标显著相关,对疾病的严重程度及预后具有重要的预测价值。
Objective To investigate the value of myoglobin（ Mb） in predicting the severity and prognosis of severe pneumonia.Methods Forty-five patients with severe pneumonia were selected as severe group and 40 patients with general pneumonia were selected as general group.All patients were given cluster treatment.The Acute Physiology and Chronic Health Enquiry II（ APACHE II）and sequential organ failure assessment（ SOFA） were used for evaluation before treatment.Venous blood was collected to detect the levels of serum Mb,cardiac troponin I（ cTnⅠ）,procalcitonin（ PCT） and C reactive protein（ CRP）,and arterial blood was collected to determine the serum lactic acid level.The relationship between Mb and other indexes was evaluated.The patients in the severe group were further divided into death and survival subgroups according to their prognosis.The dynamic monitoring levels of Mb were compared between the two subgroups.Results The scores of APACHE II and SOFA,serum levels of Mb,cTnⅠ,PCT,CRP and lactic acid in the severe group were significantly higher than those in the general group（ P〈0. 05）.In the severe group,Mb was positively correlated with APACHE II score,SOFA score,PCT,CRP,cTnⅠ and lactic acid（ P〈0. 05）. The mortality in the severe group during hospitalization was significantly higher than that in the general group（ P〈0. 05）. The serum Mb level was increased continuously in the death subgroup after admission.The serum Mb level in the survival subgroup was increased moderately,and then,became stable,and gradually decreased after 48 h.The serum Mb levels in the death subgroup at different time points after admission were significantly higher than those in the survival subgroup（ P〈0. 05）.Conclusion Mb is significantly related to common clinical indicators of severe pneumonia.It is of valuable in predicting the severity and prognosis of severe pneumonia.
作者
赵娟
ZHAO Juan(Department of Respiratory, Deyang Second People＇s Hospital, Deyang 618000, China)
出处
《实用医院临床杂志》
2018年第3期119-122,共4页
Practical Journal of Clinical Medicine
