重症肺炎患者血清胆碱酯酶含量变化及其与急性病生理学和长期健康评价Ⅱ评分、多器官功能障碍综合征评分的相关性研究  

Correlation of serum cholinesterase and acute physiology and chronic health evaluation Ⅱscore and multiple organ dysfunction syndrome score in patients with severe pneumonia

作　　者：莫新[1] 梁艳冰[2] 陈志斌[2] 李振宇[2] 杨冰玉[1] 马中富[2] 

机构地区：[1]佛山市第三人民医院神经内科,广东佛山528000 [2]中山大学附属第一医院普内科,广东广州510080

出　　处：《中华危重症医学杂志（电子版）》2016年第3期159-162,共4页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：广东省佛山市医学类科技攻关项目(2015AB00384)

摘　　要：目的探讨重症肺炎患者血清胆碱酯酶(S-Ch E)含量的变化及其与急性病生理学和长期健康评价Ⅱ(APACHEⅡ)评分、多器官功能障碍综合征(MODS)评分的相关性。方法选择重症肺炎患者86例(重症肺炎组),根据住院期间内是否死亡将研究对象分为存活组(46例)和死亡组(40例)。并同期选择普通肺炎患者100例(普通肺炎)及健康体检者124例(对照组)为对照。采集所有病例进入ICU后24 h内S-Ch E水平,并计算其APACHEⅡ评分、MODS评分情况。采用Pearson相关分析对S-Ch E水平与APACHEⅡ评分、MODS评分进行相关性研究。结果重症肺炎患者组的S-Ch E含量为(3 679±1 433)U/L,普通肺炎组为(5 142±1 884)U/L,对照组为(8 469±1 377)U/L,重症肺炎组的S-Ch E含量明显低于普通肺炎组和对照组(P均<0.05)。重症肺炎患者死亡组的S-Ch E含量明显低于存活组[(2 748±826)U/L vs.(4 489±1 360)U/L,t=7.041,P<0.001],而APACHEⅡ评分[(26±5)分vs.(16±5)分,t=8.540,P<0.001]、MODS评分[(8.15±2.49)分vs.(4.35±2.01)分,t=7.832,P<0.001]则分别明显高于存活组。同时,重症肺炎患者S-Ch E含量与APACHEⅡ评分(r=-0.437,P<0.05)、MODS评分(r=-0.337,P<0.05)均存在显著负相关。结论重症肺炎患者的S-Ch E含量明显降低,其高低能反映重症肺炎患者病情的轻重,并与APACHEⅡ评分、MODS评分呈负相关。Objective To observe the change of serum cholinesterase（S-Ch E） levels in patients with severe pneumonia and its correlativity with acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score and multiple organ dysfunction syndrome（MODS） score.Methods A total of 86 patients with severe pneumonia were enrolled in this study as the severe pneumonia group, and divided into the survival group（46 cases） and death group（40 cases）. And100 patients with common pneumonia（common pneumonia group） and 124 people with health examination normal（control group） were served as control. The S-Ch E levels were collected and APACHE Ⅱ score and MODS score were calculated after the patients were hospitalized in ICU within 24 hours. The Pearson correlation was used to analyze the association between S-Ch E level and APACHE Ⅱ score as well as MODS score. Results The S-Ch E levels in the severe pneumonia group, common pneumonia group and control group were（3 679 ± 1 433） U / L,（5 142 ± 1 884） U / L,（8 469 ± 1 377） U / L, respectively, and the S-Ch E levels in the severe pneumonia group were much lower than those in the common pneumonia group and control group（all P〈0.05）. Meanwhile,the S-Ch E levels in the death group [（2 748 ± 826） U / L vs.（4 489 ± 1 360） U / L, t = 7.041, P〈0.001] were much lower, whereas the APACHE Ⅱscores（26 ± 5 vs. 16 ± 5, t = 8.540, P〈0.001）and MODS scores（8.15 ± 2.49 vs. 4.35 ± 2.01,t = 7.832, P〈0.001） were higher than those in the survival group. The Pearson correlation showed that the S-Ch E levels were negative related with APACHEⅡscore（r =-0.437, P〈0.05） and MODS score（r =-0.337, P〈0.05）. Conclusion The S-Ch E levels in patients with severe pneumonia decrease remarkedly, which can reflect the severity of severe pneumonia and have negative correlation with APACHE Ⅱscore or MODS score.

关 键 词：胆碱酯酶 肺炎 急性病生理学和长期健康评价 多器官功能障碍综合征 

分 类 号：R563.1[医药卫生—呼吸系统]