一氧化碳中毒患者肺部感染的微循环状态及肺表面活性蛋白变化观察  

Change of microcirculation state and pulmonary surfactant protein in patients with carbon monoxide poisoning complicated with pulmonary infection

作　　者：刘晓晖 尤莉[2] 翟丽莉[3] 李珊 张莉 

机构地区：[1]唐山市工人医院体检内科,河北唐山063000 [2]唐山市工人医院老年病科,河北唐山063000 [3]唐山市工人医院手术室,河北唐山063000 [4]唐山市工人医院感染科,河北唐山063000

出　　处：《中华医院感染学杂志》2016年第19期4446-4448,共3页Chinese Journal of Nosocomiology

基　　金：河北省科学技术支撑计划基金资助项目(20150950)

摘　　要：目的观察与分析一氧化碳中毒患者肺部感染的微循环状态及肺表面活性蛋白的变化,以为该病患者肺部感染的预防控制提供指导依据。方法选取2013年5月-2015年12月医院收治46例一氧化碳中毒肺部感染患者为A组,同时间段46例一氧化碳中毒无肺部感染患者为B组,46名健康人员为C组,将3组甲襞微循环加权积分及血清肺表面活性蛋白水平进行比较,比较A组与B组中不同严重程度一氧化碳中毒患者的上述指标。结果 A组患者甲襞微循环加权积分中的血液流态积分、管襻形态积分、襻周状态积分及总积分分别为(1.99±0.16)、(1.05±0.11)、(0.75±0.10)分及(3.76±0.22)分,其均高于B组(1.35±0.12)、(0.67±0.07)、(0.59±0.08)分及(2.20±0.17)分及C组(0.76±0.08)、(0.35±0.04)、(0.40±0.05)分及(1.35±0.11)分,差异均有统计学意义(P<0.05);A组血清肺表面活性蛋白水平也均高于B组及C组,B组则高于C组,A组轻型、中型及重型中毒患者的检测水平也均高于B组,差异均有统计学意义(P<0.05)。结论一氧化碳中毒肺部感染患者的微循环状态及肺表面活性蛋白均相对较差,且肺部感染的存在进一步加重了其异常,因此,应重视对该类患者肺部感染的预防控制。OBJECTIVE To observe and analyze the change situation of microcirculation state and pulmonary surfactant protein in patients with carbon monoxide poisoning complicated with pulmonary infection,in order to provide guidance basis for prevention and control of pulmonary infection in patients.METHODS A total of 46 patients with carbon monoxide poisoning complicated with pulmonary infection in our hospital from May 2013 to Dec.2015 were selected as group A,another 46 patients with carbon monoxide poisoning at the same time but without pulmonary infection as group B,another 46 healthy people as group C.The nailfold microcirculation weighted integral and serum pulmonary surfactant protein levels of three groups were compared.Those indexes of patients in group A and group B with different degrees of carbon monoxide poisoning were compared too.RESULTS The blood flow pattern integral in nailfold microcirculation weighted integral,loop morphology integral,dirca loop state integral and total integral of group A were respectively（1.99±0.16）,（1.05±0.11）,（0.75±0.10）and（3.76±0.22）,and they were all significantly higher than group B（1.35±0.12）,（0.67±0.07）,（0.59±0.08）and（2.20±0.17）,group C（0.76±0.08）,（0.35±0.04）,（0.40±0.05）and（1.35±0.11）（P〈0.05）.The serum pulmonary surfactant protein level in group A was higher than that in group B and group C,and the results of group B was higher than group C,and the detection levels of group A with mild,moderate and severe of poisoning were all higher than those of group B（P〈0.05）.CONCLUSION The microcirculation state and pulmonary surfactant protein of patients with carbon monoxide poisoning complicated with pulmonary infection are relatively worse,and pulmonary infection actually makes the abnormal status even worse,so the prevention and control of pulmonary infection in those patients should be paid more attention.

关 键 词：一氧化碳中毒 肺部感染 微循环状态 肺表面活性蛋白 

分 类 号：R595.1[医药卫生—内科学]