动态监测血浆S100钙结合蛋白A9对重症继发性肺结核患者疗效与预后的判断价值  

The value of dynamic monitoring of plasma S100A9 in the treatment and prognosis of patients with severe secondary tuberculosis

作　　者：刘硕[1] 骆宝建[2] 韩芬[2] 刘秋月[2] Liu Shuo;Luo Baojian;Han Fen;Liu Qiuyue(Department of Pharmacy,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Intensive Care Unit,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院药剂科,北京101149 [2]首都医科大学附属北京胸科医院重症医学科,北京101149

出　　处：《中国医刊》2021年第7期729-732,共4页Chinese Journal of Medicine

基　　金：北京市医院管理局青年人才培养“青苗”计划(QML20181603)。

摘　　要：目的探讨动态监测血浆S100钙结合蛋白A9(S100 calcium-binding protein A9,S100A9)对重症继发性肺结核患者的疗效判断和预后指导意义。方法选择2018年1月至2018年12月首都医科大学附属北京胸科医院收治的重症继发性肺结核患者121例,根据治疗前血浆S100A9水平分组,S100A9>21.70μg/L的44例患者纳入高S100A9组,S100A9≤21.70μg/L的77例患者纳入低S100A9组。比较两组患者入院第1天、治疗30d、治疗180d的临床资料。根据治疗180d时患者的转归,将病情好转者纳入好转组,病情未好转者纳入未好转组,比较两组患者S100A9水平差异。结果治疗30d及180d,低S100A9组患者的痰菌阴转率及好转比例均较高于高S100A9组,死亡比例均低于高S100A9组,差异有显著性(P<0.001)。治疗30d,低S100A9组患者空洞闭合率高于高S100A9组,差异有显著性(P=0.046)。入院后,未好转组第1天S100A9水平明显高于好转组,差异有显著性(P<0.001),而治疗30d及180d时两组S100A9水平比较差异无显著性(P>0.05)。结论血浆S100A9水平对重症继发性肺结核患者具有良好的疗效判断和预后指导价值。Objective To evaluate the value of plasma S100 calcium-binding protein A9(S100A9)in the curative effect and predict outcomes of patients with severe secondary pulmonary tuberculosis.Method One hundred and twenty-one cases of patients with severe secondary pulmonary tuberculosis patients were enrolled in this study.Patients were divided into a high S100A9 group(S100A9>21.70μg/L)and a low S100A9 group(S100A9≤21.70μg/L).The two groups of patients were compared on the outcomes and curative effect on the first day of admission,the 30th and the 180th day of treatment.Subgroup analysis of the different concentrations of S100A9 between patients who cured and not cured.Result On the 30th and 180th days of treatment,the low S100A9 group had a higher sputum negative conversion rate,a higher cured ratio,and a lower mortality rate.On the 30th days of treatment,the low S100A9 group had a higher cavitary closure rate.In the subgroup analysis,the curd patients had lower S100A9 levels on admission to the hospital.Conclusion Plasma S100A9 has good clinical values in the curative effect and predicts outcomes of patients with severe secondary pulmonary tuberculosis.

关 键 词：继发性肺结核 S100钙结合蛋白A9 预后 治疗 

分 类 号：R521[医药卫生—内科学]