100例新型冠状病毒肺炎重型患者C反应蛋白、血清前白蛋白及胆碱酯酶水平分析及预后  

Serum C-reactive protein,cholinesterase and prealbumin are correlated with prognosis of severe coronavirus disease 2019 patients

作　　者：王鹤[1] 胡岚[1] 白国强[2] 刘壮[2] 于刚刚[3] 王维[3] 孙麓[4] Wang He;Hu Lan;Bai Guoqiang;Liu Zhuang;Yu Ganggang;Wang Wei;Sun Lu(Department of Infectious Disease,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Critical Care Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Respiratory Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of General Department,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China)

机构地区：[1]首都医科大学附属北京友谊医院感染内科,100050 [2]首都医科大学附属北京友谊医院重症医学科,100050 [3]首都医科大学附属北京友谊医院呼吸内科,100050 [4]华中科技大学同济医学院附属协和医院西院区综合科,武汉430056

出　　处：《中华内科杂志》2021年第2期134-138,共5页Chinese Journal of Internal Medicine

摘　　要：目的回顾分析新型冠状病毒肺炎(新冠肺炎)重症患者C反应蛋白(CRP)、血清胆碱酯酶(ChE)以及前白蛋白(PA)水平与患者临床转归间的关系。方法2020年1月29日至3月30日,武汉华中科技大学同济医学院附属协和医院西院区的北京援鄂医疗队共收治344例新冠肺炎患者,根据入选和排除标准本研究共收集100例资料完整的新冠肺炎重症患者。根据转归分为死亡组(37例)及生存组(63例),比较两组血清CRP、ChE、PA水平及临床特点,用SPSS 25.0进行统计分析。结果100例患者中男性53例(53%),略多于女性;76例患者出现CRP升高,且死亡组CRP水平显著高于生存组[(95.72±39.56)mg/L比(22.21±20.75)mg/L,P<0.01],死亡组ChE[(5082±1566)U/L比(7075±1680)U/L,P<0.01]与PA[(86.18±47.94)mg/L比(167.40±57.82)mg/L,P<0.01]水平显著低于生存组;单因素回归分析提示,CRP、PA均对重症患者生存率有影响,但多因素Cox回归分析则显示仅CRP是影响患者生存率的独立危险因素。结论在新冠肺炎重症患者中CRP普遍升高,CRP及PA水平与患者生存率有一定关系,CRP为生存率独立的危险因素,对预后具有重要预测价值。Objective To retrospectively analyze the relationship between serum C-reactive protein(CRP),serum cholinesterase(ChE),prealbumin(PA)and mortality in severe patients with coronavirus disease 2019(COVID-19).Methods During the period from January 29 to March 30,2020,a total of 344 COVID-19 patients were admitted to west branch of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology.One-hundred and ninety-two patients were diagnosed with common type and excluded,and 34 patients were transferred to LeiShenShan or other medical units.The remaining 118 patients were severe cases,and 18 cases were excluded due to incomplete data.A total of 100 severe COVID-19 patients were finally collected.According to the outcome,the patients were divided into death group(37 cases)and survival group(63 cases),and the levels of serum CRP,ChE and PA were compared.Statistical analysis were performed by SPSS25.0.Results There were 53 male patients in this study.The level of CRP in death group was significantly more elevated compare to the survival group[(95.72±39.56)mg/L vs.(22.21±20.75)mg/L,P<0.01].On the contrary,serum ChE in death group was remarkably decreased[(5082±1566)U/L vs.(7075±1680)U/L,P<0.01].Also,serum PA in death group was significantly lower[(86.18±47.94)mg/L vs.(167.40±57.82)mg/L,P<0.01].Univariate analysis showed that CRP and PA had an impact on the survival of critical patients,but multivariate Cox regression analysis suggested that CRP was the independent factor affecting the survival of critical patients.Conclusions CRP is generally elevated in severe patients with COVID-19,and serum ChE and PA accordingly decrease.CRP and PA have influence on patients′survival,but only CRP demonstrates predictive value for prognosis in critical patients with COVID-19.

关 键 词：新型冠状病毒 重症 C反应蛋白 前白蛋白 胆碱酯酶 

分 类 号：R563.1[医药卫生—呼吸系统]