血清前白蛋白动态变化评估重症社区获得性肺炎预后的价值

目的探讨血清前白蛋白评估重症社区获得性肺炎(SCAP)患者预后的临床价值。方法回顾性分析2010年8月至2014年8月西安医学院第一附属医院收治的87例SCAP患者的临床资料,按预后分为治愈组(64例)、死亡组(23例),检测两组患者入院第1天,第5天及观察终点(出院或死亡前最后一次,平均(19.2±5.7)天)血清前白蛋白含量,用统计软件SPSS19.0进行数据分析,定性资料采用χ~2检验,计量资料两两比较采用独立样本t检验,组内不同时间点数据比较采用重复测定方差分析。结果血清前白蛋白在治愈组和死亡组入院第1天比较差异无统计学意义(P0.05),第5天及观察终点比较差异具有统计学意义(P0.01)。并且治愈组血清前白蛋白在第1天,第5天和观察终点逐渐升高,而死亡组血清前白蛋白逐渐下降,同一组不同时间点数据两两比较差异具有统计学意义(P0.01)。结论血清前白蛋白持续低水平提示病情危重,预后不佳。动态观察血清前白蛋白水平对判断SCAP预后有一定的评估价值。

Dynamic observation on serum prealbumin to evaluate the prognosis of patients with severe community-ac-quired pneumonia

Objective To investigate the prognostic value of serum prealbumin level in patients with severe community-acquired pneumonia ( SCAP) . Methods The clinical data of 87 patients with SCAP were retrospectively analyzed, who were admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hos-pital of Xi'an Medical University from August 2010 to August 2014. They were divided into the survival group (64 ca-ses) and the death group (23 patients). Serum prealbumin was measured at Day 1 and 5, and the clinical endpoint ( the final measurement before hospital discharge or death, mean ( 19. 2 ± 5. 7 ) days ) . The clinical data were analyzed by spss statistics version 19. 0. The qualitative data were analyzed byχ2 test, t test of independent samples between the two groups, and repeated analysis of variance in each group. Results There was no significant differ-ence in serum prealbumin on Day 1 between the two groups (P>0. 05). On Day 5 and at the clinical endpoint, it showed significant difference ( P<0. 01 ) . The level of serum prealbumin increased progressively from Day 1 to the clinical endpoint in the survival group, but it decreased in the death group (P<0. 01). Conclusion The low level of serum prealbumin indicates poor outcome for patients with SCAP. Dynamic observation of serum prealbumin level has prognostic value in predicting the outcome of SCAP.