重症肺炎患者C-反应蛋白、磷酸肌酸激酶同工酶及乳酸脱氢酶水平变化及临床意义  

Changes andclinical significance of the levels of CRP,CK-MB,and LDH in patients with severe pneumonia

作　　者：刘晓曼 陈旭[1] 张新征[1] LIU Xiao-man;CHEN Xu;ZHANG Xin-zheng(Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《实用医院临床杂志》2022年第3期174-177,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析重症肺炎患者C-反应蛋白(CRP)、磷酸肌酸激酶同工酶(CK-MB)和乳酸脱氢酶(LDH)水平变化情况及临床意义。方法2018年4月至2021年5月我院收治的126例重症肺炎(重症组)与91例轻症肺炎(轻症组)患者,选取同期体检健康者106例为健康组。比较三组血清中CRP、CK-MB、LDH水平,及上述因子水平与重症肺炎患者病情相关性。于观察期(28 d)内对出院患者进行电话或门诊随访。将重症组分为生存组和死亡组,比较不同预后患者CRP、CK-MB及LDH水平;绘制受试者工作特征(ROC)曲线分析上述因子对重症肺炎的预测价值。结果三组CRP、CK-MB及LDH水平比较,健康组<轻症组<重症组(P<0.05)。不同PSI评分患者CRP、CK-MB及LDH水平比较,低度组<中度组<重度组(P<0.05);CRP、CK-MB及LDH与PSI评分均为正相关(P<0.05)。126例患者观察期死亡26例,生存100例,生存组CRP、CK-MB及LDH水平均低于死亡组(P<0.05);三者联合检测对重症肺炎预测敏感度和特异度分别为90.20%、85.80%;曲线下面积(AUC)为0.904,明显高于各项指标单独预测(P<0.05)。结论CRP、CK-MB及LDH水平异常与重症肺炎发生、发展可能存在联系,在临床中监测三者水平变化可为临床诊疗重症肺炎,评估患者预后提供更全面参考信息。Objective To analyze the changes of the levels of C-reactive protein(CRP),creatine kinase isoenzyme(CK-MB)and lactate dehydrogenase(LDH)in patients with severe pneumonia and their clinical significance.Methods One hundred and twenty-six patients with severe pneumonia(severe group)and 91 patients with mild pneumonia(mild group)admitted to our hospital from April 2018 to May 2021 were selected.Another 106 healthy people who had physical examination during the same period in our hospital were selected as a healthy group.The levels of serum CRP,CK-MB and LDH and the correlation between the levels of the above factors and the condition of patients with severe pneumonia were compared among the three groups.During the observation period(28days),the discharged patients were followed up by telephone or outpatient service.The severe group was further divided into a survival group and a death group,and the levels of CRP,CK-MB,and LDH in patients with different prognosis were compared.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of the above factors for severe pneumonia.Results Comparison of the levels of CRP,CK-MB and LDH among the three groups showed that the healthy group<the mild group<the severe group(P<0.05).Comparison of the levels of CRP,CK-MB and LDH in patients with different pneumonia severity index(PSI)scores showed that the low group<the moderate group<the severe group(P<0.05).The correlation analysis results showed that CRP,CK-MB,LDH and PSI scores were all positive correlated(P<0.05).Of the 126 patients,26 died during the observation period and 100 survived.The levels of CRP,CK-MB and LDH in the survival group were significantly lower than those in the deathgroup(P<0.05).The ROC curve analysis showed that the sensitivity and specificity of the three combined detection for predicting severe pneumonia were 90.20%and 85.80%,respectively.The area underthe curve(AUC)of the three combined detection was 0.904,which was significantly higher than that of the individual predict

关 键 词：重症肺炎 C-反应蛋白 磷酸肌酸激酶同工酶 乳酸脱氢酶 

分 类 号：R563.1[医药卫生—呼吸系统]