老年心衰合并肺部感染患者血清CHE、Cys C和氧化应激指标变化  

Variation levels of serum CHE, Cys C and oxidative stress in elderly patients with heart failure complicated with pulmonary infection

作　　者：王艳华[1] 刘泉源[2] 卢金凤[3] 崔秀峰[4] 刘爱云[5] 杜海岭[6] WANG Yan-hua;LIU Quan-yuan;LU Jin-feng;CUI Xiu-feng;LIU Ai-yun;DU Hai-ling(Affiliated Hospital of Binzhou Medical College,Binzhou,Shandong256000,China;不详)

机构地区：[1]滨州医学院附属医院CCU,山东滨州256000 [2]滨州医学院附属医院放射科,山东滨州256000 [3]滨州医学院附属医院口腔外科,山东滨州256000 [4]滨州医学院附属医院创伤骨科,山东滨州256000 [5]滨州医学院附属医院呼吸内科,山东滨州256000 [6]滨州医学院附属医院急诊科,山东滨州256000

出　　处：《中华医院感染学杂志》2020年第16期2452-2456,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展项目(2017WS372)。

摘　　要：目的探究老年心衰合并肺部感染患者血清胆碱酯酶(Cholinesterase,CHE)、胱抑素C(Cystatin C,Cys C)和氧化应激指标的变化及意义。方法选取2018年1月-2019年1月滨州医学院附属医院收治的118例老年心力衰竭患者,其中合并肺部感染患者70例为感染组,未发生肺部感染患者48例为未感染组,根据病情转归情况将感染组患者分为存活组50例、死亡组20例。检测血清CHE、Cys C和氧化应激指标[(丙二醛(Malondi-aldehyde,MDA)、超氧化物歧化酶(Superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-P_X)]水平。分别比较感染组与未感染组,死亡组与存活组患者血清CHE、Cys C和MDA、SOD、GSH-Px水平变化。采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清CHE、Cys C和MDA、SOD、GSH-Px水平对老年心衰合并肺部感染预后诊断价值。结果入院时,与未感染组比,感染组患者血清CHE、SOD、GSH-Px水平较低,血清Cys C和MDA水平较高(P<0.05);入院时,与存活组比,死亡组患者血清CHE、SOD、GSH-Px水平降低,血清Cys C和MDA水平升高(P<0.05);与单独指标比,联合检测AUC、特异性、灵敏度、阳性预测值、阴性预测值升高(P<0.05)。结论联合检测血清CHE、Cys C和MDA、SOD、GSH-Px水平对老年心力衰竭合并肺部感染患者预后具有较高的诊断价值。OBJECTIVE To explore the changes and significance of serum cholinesterase(CHE), Cystatin C(Cys C) and oxidative stress in elderly patients combined with heart failure and pulmonary infection. METHODS From Jan. 2018 to Jan. 2019, 118 elderly patients with heart failure were recruited, including 70 patients with pulmonary infection as the infection group and 48 patients without pulmonary infection as the uninfected group. According to the outcome of the disease, the patients in the infection group were divided into the survival group with 50 patients and the death group with 20 patients. The levels of serum ChE, Cys C and oxidative stress indexes such as malondi aldehyde(MDA), superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px)) were measured. The changes of serum ChE, Cys C, MDA, SOD and GSH PX between the infection group and the uninfected group, the dead group and the surviving group were compared. ROC curve was used to analyze the serum ChE, Cys C, MDA, SOD and GSH PX levels in the prognosis and diagnosis of elderly heart failure with pulmonary infection. RESULTS Compared with the uninfected group, the levels of Che, SOD and GSH PX in the infection group were significantly lower;the levels of Cys C and MDA in the infection group were significantly higher(P<0.05). Compared with the living group, the levels of Che, SOD and GSH PX in the dead group were significantly lower, and Cys and MDA in the dead group were significantly higher(P<0.05). The AUC, specificity, sensitivity, positive predictive value, negative predictive value of combined indexes were significantly higher than that of the single index(P<0.05). CONCLUSION The combined detection of serum ChE, Cys C, MDA, SOD and GSH PX had high diagnostic value for the prognosis of elderly patients with heart failure and pulmonary infection.

关 键 词：心力衰竭 肺部感染 胆碱酯酶 胱抑素C 氧化应激 预后 

分 类 号：R563.1[医药卫生—呼吸系统]