社区获得性肺炎患者血清丙二醛和血清总抗氧化力水平测定的临床意义  

Clinical significance of serum malondialdehyde and total antioxidative capacity in the patients with community-acquired pneumonia

作　　者：李元芹[1] 朱述阳[1] 陈碧[1] 刘平莉[1] 

机构地区：[1]江苏省徐州医学院附属医院呼吸科,221002

出　　处：《国际呼吸杂志》2012年第23期1774-1778,共5页International Journal of Respiration

摘　　要：目的观察社区获得性肺炎（CAP）患者血清丙二醛（MDA）和血清总抗氧化力（T—AOC）水平的变化，探讨其临床意义。方法以徐州医学院附属医院呼吸科2010年9月-2011年9月收治的90例CAP患者[男54例，女36例，平均年龄（54±20）岁]和30名同期在我院体检健康者[男20名，女10名，平均年龄（52±11）岁]为研究对象。CAP患者进行肺炎严重指数（PSI）评分，将其分为Ⅰ～Ⅲ级低危险组46例，Ⅳ～Ⅴ级为高危险组44例；检测血清MDA和血清T-AOC水平。组间采用t检验或者χ2检验；CAP组中根据患者存活或死亡的转归，进行Logistic回归分析。结果CAP组血清MDA[（6．5±2．4）μmol／L]高于对照组[（3．6±0．3）μmol／L]；CAP组血清T—AOCE（12．6±1．6）U／ml]低于对照组[（17．7±2．1）U／ml]；高危险组及死亡组血清MDA[（8．1±2．5）μmol／L；（9．9±1．6）μmol／L]高于低危险组及存活组[（4．9±0．7）μmol／L；（6．1±2．2）μmol／L]；高危险组及死亡组血清T-AOCE（11．5±1．6）U／ml；（10．6±1．5）U／ml]低于低危险组及存活组[（13．6±0．6）U／ml；（12．8±1．4）U／ml]；血清MDA与PSI评分呈正相关，相关系数为0．745；差异均有统计学意义（P〈0．05）。经过有效治疗后血清MDA水平总体呈下降趋势，血清T—AOC呈上升趋势。Logistic回归分析血清MDA是影响CAP患者预后的危险因素。结论CAP患者血清MDA水平能够反应病情的严重程度及判断预后。动态监测血清MDA和T—AOC水平可以帮助判断治疗效果。Objective To observed serum malondialdehyde（MDA） and total antioxidative capacity （T-AOC） in patients with CAP and to explore their clinical significance. Methods 90 cases of hospitalized CAP （including 54 males and 36 females with a mean age of 54±20 years） were recruited from the respiratory wards in the affiliated Hospital of Xuzhou Medical College from September 2010 to September 2011 and 30 cases （including 20 males and 10 females with a mean age of 52±11 years） of healthy physical examination in our hospital served as the control. We collected clinical variables of all patients after they were hospitalized within 24 hours and calculated PSI score. The CAP patients were divided into 2 groups：grade Ⅰ-Ⅲ as the low-risk group （ n = 46） and grade Ⅳ-Ⅴ as the high-risk group （ n = 44） according to PSI score. Serum MDA and total T-AOC were also measured. We adopted t test or χ2 test in the comparison between the groups. And performed the logistic regression analysis and found independent risk factors which had important effect on clinical. Results Serum MDA concentration of CAP patients [（6.5±2.4） μmol/L],the high-risk group [（8.1±2.5） μmol/L] and the death group [（9.9±1.6） μmol/L] were significantly higher than those of the control group [（3.6± 0.3） μmol/L], the low-risk group [（4.9± 0.7） μmol/L] and the survival group [（6.1 ± 2.2） μmol/L]. Serum TAOC concentration of CAP patients [ （12.6±1.6） U/ml], the high-risk group [ （ 11.5±1.6） U/ml] and the death group [（10. 6±1. 5） U/ml]were significantly lower than those of the control group [（17.7±2.1） U/ml],the low risk group [（13.6±0.6） U/ml] and the survival group [（12.8±1.4） U/ml] （ P〈0.05, respectively）. There were positive correlation between the serum MDA and PSI score （ r = 0. 745） （ P〈0.05）. Serum MDA concentration of the survival patients after the treatment were significantly lower than those before the treatment. Serum T-AOC concentration of

关 键 词：社区获得性肺炎 血清丙二醛 血清总抗氧化能力 

分 类 号：R563.1[医药卫生—呼吸系统]