老年细菌性肺炎患者血清脂联素和瘦素变化  

Changes of serum adiponectin and leptin in elderly patients with bacterial pneumonia

作　　者：左蓓[1] 刘向群[1] 崔文洁[1] 王淑玲[1] 李涛[1] 施海[1] ZUO Bei;LIU Xiang-qun;CUI Wen-jie;WANG Shu-ling;LI Tao;SHI Hai(Xuzhou First People's Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市第一人民医院呼吸二科,江苏徐州221000

出　　处：《中华医院感染学杂志》2020年第4期512-516,共5页Chinese Journal of Nosocomiology

基　　金：徐州市科学技术局基金资助项目(KC16SH034)。

摘　　要：目的探讨老年细菌性肺炎患者的血清脂联素和瘦素变化和临床意义。方法选择2017年10月-2018年3月于徐州市第一人民医院进行治疗的细菌性肺炎老年患者70例和体检健康者50名为研究对象,其中重症肺炎患者34例设为A组,普通肺炎患者36例设为B组,健康者50名设为C组,比较三组研究对象的血清脂联素和瘦素及降钙素原(PCT)和C-反应蛋白(CRP)。结果A组和B组患者的痰液标本共培养出90株病原体,其中革兰阴性菌56株占62.22%,革兰阳性菌34株占37.78%。三组的脂联素,瘦素,CRP,PCT的浓度数据差异均具有统计学意义(P<0.05),脂联素的浓度为A组(4.78±1.84)mg/L低于B组(6.72±1.69)mg/L,B组低于C组(P<0.05),瘦素、CRP、PCT为A组(17.48±4.20)μg/L、(89.32±23.00)μg/L、(4.02±2.21)μg/L高于B组(12.96±2.09)μg/L、(70.34±26.74)μg/L、(3.50±1.85)μg/L,B组高于C组(P<0.05)。三组研究对象的数据中,脂联素与瘦素,CRP,PCT之间均呈负相关(r=-0.321,-0.251,-0.304,P均<0.001),瘦素与CRP,PCT之间呈正相关(r=0.354,0.384,P均<0.001),CRP与PCT之间呈正相关(r=0.332,P<0.001)。利用脂联素,瘦素,CRP,PCT对A组和B组患者进行诊断,最佳截断值分别为5.74 mg/L,15.44μg/L,75.59μg/L,3.13μg/L,约登指数分别为48.37%,65.36%,43.14%,17.65%。结论血清脂联素和瘦素对细菌性肺炎老年患者病情的严重程度具有一定的指示作用,但是实际的临床工作中影响因素众多,情况较为复杂,应在指标的指示下对患者的情况进行综合考虑。OBJECTIVE To investigate the changes and clinical significance of serum adiponectin and leptin in elderly patients with bacterial pneumonia.METHODS A total of 70 elderly patients with bacterial pneumonia treated in Xuzhou First People’s Hospital from Oct.2017 to Mar.2018 and 50 healthy people who underwent physical examination were selected as the research subjects,of which 34 patients with severe pneumonia were assigned to group A,36 patients with ordinary pneumonia were assigned to group B,and 50 healthy persons were assigned to group C.The serum adiponectin and leptin,procalcitonin(PCT)and C-reactive protein(CRP)of the three groups were compared.RESULTS A total of 90 pathogens were cultured from the sputum samples of patients in group A and group B,among which 56 Gram-negative bacteria accounted for 62.22%,and 34 Gram-positive bacteria accounted for 37.78%.The differences in the concentration data of adiponectin,leptin,CRP,and PCT among the three groups were significant(P<0.05).The concentration of adiponectin was(4.78±1.84)mg/L in group A,significantly lower than that in group B(6.72±1.69 mg/L),and group B was significantly lower than group C(P<0.05).Leptin,CRP,and PCT in Group A were(17.48±4.20)μg/L,(89.32±23.00)μg/L,(4.02±2.21)μg/L,respectively,significantly higher than those in Group B(12.96±2.09)μg/L,(70.34±26.74)μg/L,and(3.50±1.85)μg/L,respectively,and group B was significantly higher than group C(P<0.05).In the data of the three groups of patients,adiponectin was negatively correlated with leptin,CRP,and PCT(r=-0.321,-0.251,-0.304,P<0.001),and leptin was positively correlated withCRP and PCT(r=0.354,0.384,P<0.001),and there was a positive correlation between CRP and PCT(r=0.332,P<0.001).Adiponectin,leptin,CRP,and PCT were used to diagnose patients in group A and B.The optimal cutoff values were 5.74(mg/L),15.44(μg/L),75.59(μg/L),and 3.13(μg/L),and the Yoden index was 48.37%,65.36%,43.14%,17.65%,respectively.CONCLUSION Serum adiponectin and leptin had a certain indicating effect on the

关 键 词：细菌性肺炎 脂联素 瘦素 重症肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]