血清S-ChE PAB Apo A1及APACHEⅡ评分对重症肺炎预后的评估

doi:10.3969/j.issn.1006-6233.2018.04.004

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Abstract Objective: To study the evaluation of prognosis of severe pneumonia by serum cholinesterase (S-ChE), prealbumin(PAB), apolipoprotein A1 (Apo A1) and Acute physiology and chronic health scoring system II (APACHE II) score. Methods: 70 patients of severe pneumonia admitted in our hospital from March 2015 to March 2017 were selected as research objects. According to the APACHE score<20 divided into A group, APACHE score≥20 were divided into B group, the incidence of multiple organ dysfunction syndrome (MODS) and fatality rate were compared between the two groups; depending on whether MODS occurred divided into MODS and non MODS groups, according to the prognosis after 28d, the patients were divided into the fatality group and the survival group, the differences of serum S-ChE, PAB, Apo A1 and APACHE II scores between the two groups were compared. Results: The incidence of the MODS and fatality rate in Agroup were significantly lower than those in group B [17.24%(5/29) vs 43.90% (18/41), 10.34% (3/29) vs 41.46% (17/41)] (P<0.05); the serum S-ChE, PAB, Apo A1 in MODS group were significantly lower than those in non MODS group [(2.84±0.33)kU/L vs (4.53±0.40)kU/L, (118.45±15.20)mg/L vs (204.61±17.92)mg/L, (0.60±0.11)g/L vs (1.15±0.21)g/L], the APACHE score was higher than those in non MODS group [(26.91±2.74) score vs (19.58±2.04)score], the difference was statistically significant (P<0.05); the serum S-ChE, PAB, Apo A1 in fatality group were significantly lower than those in survival group [(2.75±0.31)kU/L vs (4.46±0.29)kU/L, (109.86±15.73)mg/L vs (184.51±16.85)mg/L, (0.59±0.12)g/L vs (1.12±0.18)g/L], the APACHE score was higher than those in survival group [(28.95±2.40) score vs (18.58±1.97) score], the difference was statistically significant (P<0.05); the Logistic regression analysis showed that the scores of S-ChE, PAB, Apo, A1 and APACHE II were independent risk factors for the prognosis of severe pneumonia (OR=0.082, 0.137, 0.096, 1.798, P<0.05). Conclusion: The serum S-ChE, PAB, Apo A1 and APACHE II scores have a good evaluation value in the prognosis of severe pneumonia.

Key words： Severe pneumonia Cholinesterase Prealbumin Apolipoprotein A1

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2018.04.004 OR http://www.hbyxzzs.cn/EN/Y2018/V24/I4/540

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