老年重症肺炎患者炎症因子、D-dimer和血浆纤维结合蛋白动态监测的临床预后价值  

Value of Dynamic Monitoring of Inflammatory Factors,D-Dimer and Plasma Fibronectin in the Clinical Prognosis of Elderly Patients with Severe Pneumonia

作　　者：李娜[1] LI Na(Department of Critical Care Medicine,The Third Affiliated Hospital of Xinxiang Medical University,Xinxiang Henan 453800,China)

机构地区：[1]新乡医学院第三附属医院重症医学,河南新乡453800

出　　处：《临床研究》2022年第2期40-43,共4页Clinical Research

摘　　要：目的通过回顾性分析,分析老年重症肺炎患者动态监测D-二聚体(D-dimer,D-D)、血清炎症因子和血浆纤维结合蛋白(Fn)对病情严重程度及预后的临床作用。方法抽取68例老年重症肺炎患者作为研究对象,均源自于新乡医学院第三附属医院2019年10月至2021年10月收入,根据患者临床治疗结局分为死亡组(n=27)与幸存组(n=41),详细记录所有患者基线资料(例如性别、年龄及病史等)。同时积极检测患者入院时、入院3 d、7 d的生命体征、血生化、血气分析、血常规等指标,并根据结果开展急性生理与慢性健康评估评分(APACHEⅡ),详细记录各时间点患者血清炎症因子、D-D及Fn指标状况。结果幸存组患者各时间段APACHEⅡ评分均低于死亡组,同时幸存组患者呈降低趋势,死亡组呈升高趋势,差异有统计学意义(P<0.05);两组患者入院时炎症因子水平比较,差异无统计学意义(P>0.05),入院3 d、7 d后幸存组患者炎症因子呈降低趋势发展,差异有统计学意义(P<0.05),而死亡组虽略有上升趋势,但差异无统计学意义(P>0.05);幸存组患者D-D指标各时间段均低于死亡组,且Fn指标各时间段均高于死亡组,差异有统计学意义(P<0.05),幸存组患者D-D指标呈降低趋势、Fn指标呈上升趋势发展,死亡组患者Fn指标呈降低趋势发展,差异有统计学意义(P<0.05),而死亡组D-D指标略有上升趋势,但差异无统计学意义(P>0.05)。结论对于老年重症肺炎患者应用炎症因子、D-D及Fn指标进行动态监测,均可起到分析病情严重程度及预后的效果,且D-D及Fn指标对患者病情预后判断价值更高,具有推广价值。Objective The clinical effects of dynamic monitoring of D-dimer(D-D),serum inflammatory factors and plasma fiber-binding protein(Fn)on the severity and prognosis of senile patients with severe pneumonia were analyzed retrospectively.Methods A total of 68 elderly patients with severe pneumonia admitted to the Third Affiliated Hospital of Xinxiang Medical College from October 2019 to October 2021 were selected as the research objects,and divided into death group(n=27)and survival group(n=41)according to clinical treatment outcome.The baseline information of all patients(such as gender,age and medical history,etc.)was recorded in detail.Vital signs,blood biochemistry,blood gas analysis and blood routine were detected at admission,3 d and 7 d,and acute physiology and chronic health assessment score(APACHEⅱ)was carried out according to the results.Serum inflammatory factors,D-D and Fn indexes of patients at each time point were recorded in detail.Results The APACHEⅡscore of the survival group was lower than that of the death group at all time periods,and the survival group showed a decreasing trend,while the death group showed an increasing trend,with statistical significance(P<0.05).There was no statistically significant difference in the levels of inflammatory factors between the two groups at admission(P>0.05).After admission for 3 days and 7 days,the inflammatory factors in the survival group showed a decreasing trend,with a statistically significant difference(P<0.05),while the inflammatory factors in the death group showed a slight increasing trend,but there was no statistically significant difference(P>0.05).D-d index in the survival group was lower than that in the death group at all time periods,and Fn index was higher than that in the death group at all time periods,with statistical significance(P<0.05).The D-D index and Fn index in the survival group showed a decreasing trend,while Fn index in the death group showed a decreasing trend,and the differences were statistically significant(P<0.05).While the

关 键 词：老年人群 重症肺炎 炎症因子 D-二聚体 血浆纤维结合蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]