摘要
目的探讨血气、凝血功能指标及超敏C反应蛋白(hs-CRP)检测对脑血管病后遗症期长期卧床社区获得性肺炎(community acquired pneumonia,CAP)患者的临床意义。方法选取年龄> 65岁的CAP90例,将无脑血管病病史的30例作为CAP 1组,脑血管病后遗症期无长期卧床的30例作为CAP 2组,脑血管病后遗症期长期卧床的30例作为CAP 3组。另选取年龄> 65岁的健康体检者30例作为正常对照组。检测比较4组血气分析、凝血功能指标及hs-CRP。结果治疗前,CAP 1、2、3组及正常对照组血气分析、凝血功能指标及hs-CRP总体比较差异均有统计学意义(P <0. 05)。治疗前,CAP 1、2及3组二氧化碳分压(Pa CO2)、D二聚体(DD)、蛋白C(PC)及hs-CRP均高于正常对照组,氧分压(Pa O2)及抗凝血酶Ⅲ(ATⅢ)均低于正常对照组,差异有统计学意义(P <0. 05);CAP 2及3组Pa CO2、DD、PC及hs-CRP均高于CAP 1组,Pa O2及ATⅢ均低于CAP 1组,差异有统计学意义(P <0. 05);CAP 3组Pa CO2、DD、PC及hs-CRP均高于CAP 2组,Pa O2及ATⅢ均低于CAP 2组,差异有统计学意义(P <0. 05)。治疗后,CAP 1、2和3组Pa CO2均较治疗前明显降低,PaO_2均较治疗前明显升高;CAP 1组DD、PC和hs-CRP均较治疗前降低,ATⅢ较治疗前升高,差异有统计学意义(P <0. 05)。治疗后,CAP 1、2、3组及正常对照组DD、ATⅢ、PC及hs-CRP总体比较差异有统计学意义(P <0. 05)。治疗后,CAP 1、2及3组DD、PC及hs-CRP均高于正常对照组,ATⅢ均低于正常对照组,差异有统计学意义(P <0. 05);CAP 2及3组DD、PC及hs-CRP均高于CAP 1组,ATⅢ均低于CAP 1组,差异有统计学意义(P <0. 05);CAP 3组DD、PC及hs-CRP均高于CAP 2组,ATⅢ低于CAP 2组,差异有统计学意义(P <0. 05)。结论 CAP患者会出现血气紊乱、凝血功能受损及微炎症状态,且随着合并脑血管病后遗症期情况加深而加重。临床可以对脑血管病后遗症期CAP患者进行针对性的抗凝和抗感染治疗,以增强疗效。
Objective To investigate the detection significance of blood gas analysis, coagulation function index and hs-CRP in long-term bedridden patients who had sequelae of cerebrovascular disease （CVD） with community-acquired pneumonia （CAP）. Methods A total of 90 cases of CAP aged over 65 years were selected. Of them, 30 patients without a history of CVD were selected as group CAP 1, 30 patients with CVD sequelae who were not long-term bedridden as group CAP 2, and 30 long-term bedridden patients with CVD sequela as group CAP 3. Another 30 healthy subjects aged over 65 years were selected to be the normal control group. Blood gas analysis, coagulation function index and hs-CRP were compared between the 4 groups. Results Before treatment, there were significant differences in blood gas analysis, coagulation function index and hs-CRP between groups CAP 1, 2, 3 and the normal control group （ P 〈0.05）. The partial pressure of carbon dioxide （PaCO 2）, D dimer （DD）, protein C （PC） and hs-CRP of groups CAP 1, 2 and 3 were higher than those of the normal control group, while the partial pressure of oxygen （PaO 2） and antithrombin Ⅲ （AT Ⅲ） were lower than those of the normal control group （ P 〈0.05）. PaCO 2, DD, PC and hs-CRP in groups CAP 2 and 3 were higher than those ingroup CAP 1, whereas PaO 2 and AT Ⅲ were lower than those in group CAP 1, and the difference was statistically significant （ P 〈0.05）. PaCO 2, DD, PC and hs-CRP in group CAP 3 were higher than those in group CAP 2, while PaO 2 and AT Ⅲ were lower than those in group CAP 2, and the difference was statistically significant （ P 〈0.05）. After treatment, PaCO 2 in groups CAP 1, 2 and 3 was significantly lower than that before treatment, and PaO 2 was significantly higher than that before treatment. DD, PC and hs-CRP in group CAP 1 were significantly lower than those before treatment, and AT Ⅲ was significantly higher than that before treatment （ P 〈0.05）. After treatment, there were significant
作者
王彦霞
牛占丛
杨圣俊
刘军肖
许建平
苏艳
边竞
WANG Yan-xia;NIU Zhan-cong;YANG Sheng-jun;LIU Jun-xiao;XU Jian-ping;SU Yan;Bian Jing(Department of Infectious Diseases;Public Health Insurance Office;Department of Respiratory,Hebei People＇s Hospital,Shijiazhuang 050001,China)
出处
《临床误诊误治》
2018年第11期61-66,共6页
Clinical Misdiagnosis & Mistherapy
基金
2016年度河北省医学科学研究重点课题计划指令性课题(20160473)
关键词
肺炎
脑血管障碍
血气分析
凝血功能
超敏C反应蛋白
Pneumonia
Cerebrovascular disorders
Blood gas analysis
Coagulation function
hs-CRP
