C反应蛋白与前白蛋白及其比值对尘肺病合并肺部感染患者预后的评估价值  

Evaluation Value of C-reactive Protein,Prealbumin and Their Ratio in Prognosis of Patients with Pneumoconiosis Complicated with Pulmonary Infection

作　　者：刘晓琳[1] 周蜜[1] 孔玉林 闵春燕[1] LIU Xiao-lin;ZHOU Mi;KONG Yu-lin;MIN Chun-yan(Department of Occupational Disease,The Fifth People's Hospital of Suzhou,Suzhou Jiangsu 215000,China)

机构地区：[1]苏州市第五人民医院职业病科,江苏苏州215000

出　　处：《抗感染药学》2021年第10期1452-1456,共5页Anti-infection Pharmacy

基　　金：同济大学附属上海肺科医院孙道远教授职业病专家团队(项目编号:SZYJTD 201904)。

摘　　要：目的:探讨C反应蛋白(C-reactive protein,CRP)与前白蛋白(prealbumin,PA)及其比值对尘肺病合并肺部感染患者预后的评估价值。方法:选取2010年1月—2020年6月苏州市第五人民医院收治的尘肺病合并肺部感染患者129例作为研究对象,按死亡或生存情况分为死亡组(63例)和生存组(66例);检测患者血清CRP、PA水平并计算CRP/PA比值,比较2组患者的一般资料,入院后CRP和PA水平,不同分期尘肺病患者CRP和PA值及不同CRP/PA值患者病死率的差异。结果:尘肺病合并肺部感染死亡组患者的住院天数为(26.48±19.76)d,明显长于生存组为(18.61±12.73)d(P<0.05);死亡组患者入院第1天的CRP值显著高于生存组(P<0.001),PA值显著低于生存组(P<0.05);死亡组患者入院第1天与第7天的CRP值、PA值经比较其差异无统计学意义(P>0.05);而生存组患者入院第7天PA值显著高于第1天(P<0.05),CRP值低于第1天,但经比较其差异无统计学意义(P>0.05);死亡组患者入院第7天的CRP值显著高于生存组(P<0.001),PA值显著低于生存组(P<0.001);死亡组患者壹期、贰期和叁期的平均CRP值均显著高于生存组(P<0.001),平均PA值均显著低于生存组(P<0.001);死亡组患者贰期尘肺的平均PA值低于壹期和叁期患者(P>0.05),生存组患者叁期尘肺的平均CRP值高于壹期和贰期尘肺病患者,但经比较其差异无统计学意义(P>0.05);CRP/PA值为>0~0.25、>0.25~1.0和>1.0患者的病死率经比较其差异有统计学意义(P<0.001);死亡组患者的CRP/PA值为(1.09±1.88)显著高于生存组为(0.29+0.25)(P<0.05)。结论:随着CRP/PA值上升,尘肺病患者的病死率显著上升,CRP、PA及CRP/PA值可以作为尘肺病患者炎症程度及评估预后的指标;本文首次观察尘肺病患者CRP及PA水平动态变化,从而证实CRP/PA值上升将导致此类患者病死率显著上升。Objective:To evaluate the prognostic value of C-reactive protein(CRP),prealbumin(PA)and CRP/PA in pneumoconiosis patients with pulmonary infection.Methods:129 patients with pneumoconiosis complicated with pulmonary infection admitted to the Fifth People’s Hospital of Suzhou from January 2010 to June 2020 were selected as the research objects.They were divided into death group(63 cases)and survival group(66 cases)based on death or survival conditions.Serum CRP and PA levels were detected and CRP/PA ratio was calculated.Patients’general information of the two groups,CRP and PA levels after admission,CRP and PA values of pneumoconiosis patients with different stages and mortality rate of patients with different CRP/PA values were compared.Results:The CRP value on the first day of admission in the death group was significantly higher than that in the survival group(P<0.05),and the PA value on the first day was significantly lower than that in the survival group(P<0.05).In the death group,there were no significant difference in CRP,PA value on day 1 and day 7(P>0.05).In the survival group,the PA value on the 7 th day was significantly higher than that on the 1 st day(P<0.05),and the CRP value on the 7 th day was lower than that on the 1 st day,but the differences were not statistically significant(P<0.05).The mean CRP value of stageⅠ,ⅡandⅢin the death group were significantly higher than that in the survival group(P<0.001),and the mean PA value of stageⅠ,ⅡandⅢin the survival group were significantly lower than that in the survival group(P<0.001).In the death group,the mean CRP value of stageⅡpneumoconiosis patients was higher than that of stageⅠandⅢpneumoconiosis patients,and the mean PA value of stageⅡpneumoconiosis patients was lower than that of stageⅠandⅢpneumoconiosis patientst(P<0.05).In the survival group,the mean CRP value of patients with stageⅢpneumoconiosis was higher than that of patients with stageⅠandⅡ,and the mean PA value was lower than that of patients with stageⅠan

关 键 词：尘肺病 C反应蛋白 前白蛋白 死亡 预后 

分 类 号：R446.11[医药卫生—诊断学] R969.3[医药卫生—临床医学]