摘要
目的:探讨社区获得性肺炎(CAP)合并低蛋白血症的危险因素及预防措施。方法:选取2018-07—2018-10期间以CAP为首要诊断在首都医科大学附属北京朝阳医院急诊留观住院的患者,记录患者性别、年龄、合并疾病,入院时体质指数(BMI)、胃肠损伤分级(AGI)、胸腔积液、尿蛋白、血清白蛋白(ALB)、血清前白蛋白(PAB)、血红蛋白(HGB)、白细胞计数(WBC)、氧分压(PaO2)、二氧化碳分压(PaCO2)、治疗期间的ALB、PAB,出院后记录患者使用抗菌药物的种类及住院天数。分析以上指标与社区获得性肺炎合并低蛋白血症的相关性。结果:共87例CAP患者,入院时合并低蛋白血症的占56.3%(49/87)。入院时,合并低蛋白血症组与未合并低蛋白血症组患者的胃肠损伤分级、胸腔积液、尿蛋白情况比较均差异有统计学意义(P<0.05)。住院期间,年龄≥70岁的患者新发低蛋白血症的比例明显高于年龄<70岁的患者(分别为61.3%,14.3%),差异有统计学意义(P<0.05)。合并慢性疾病种类越多的患者合并低蛋白血症的发生率越高,合并低蛋白血症的患者使用抗生素的品种数增加、住院时间延长,均差异有统计学意义(P<0.05)。结论:CAP合并低蛋白血症的危险因素包括胃肠功能损伤、胸腔积液、尿蛋白阳性等,积极处理相关危险因素有利于有效防治低蛋白血症,以减少抗生素的使用及缩短患者的住院时间。
Objective: To investigate the risk factors and preventative measures of community acquired pneumonia(CAP) complicated with hypoproteinemia. Method: Patients with CAP as the primary diagnosis hospitalized in the emergency department of Beijing Chaoyang hospital affiliated to Capital University of Medical Sciences during July 2018 to October 2018 were enrolled. Record patients’ gender, age, complicating diseases. Record their body mass index(BMI), gastrointestinal injury classification(AGI), pleural effusion, urinary protein, serum albumin(ALB), serum prealbumin(PAB), hemoglobin(HGB), white blood cell count(WBC), oxygen partial pressure(PaO2), CO2 partial pressure(PaCO2) on admission, their ALB, PAB during treatment, and the antibiotic types, the hospital stay after discharge. The correlation between the above indexes and the incidence of hypoproteinemia in patients with CAP was analyzed. Result: Among 87 patients, 56.3%(49/87) were complicated with hypoproteinemia at admission. On admission, the gastrointestinal injury grade, pleural effusion and urinary protein of patients had no statistical difference(P<0.05) between the groups with and without hypoproteinemia. During hospitalization, the proportion of new cases of hypoproteinemia in patients over 70 was significantly higher than that in patients below 70(61.3%, 14.3% respectively, P<0.05). The incidence of hypoproteinemia increased in patients with more types of chronic diseases, and the patients with hypoproteinemia need more varieties of antibiotics and longer length of stay in hospital(all P<0.05). Conclusion: The risk factors of CAP associated with hypoproteinemia include gastrointestinal function injury, pleural effusion, positive urinary protein, etc. Active treatment of related risk factors is conducive to the effective prevention and treatment of hypoproteinemia, so as to reduce the use of antibiotics and shorten the length of hospitalization.
作者
夏娴娴
陈罡
刘温馨
XIA Xianxian;CHEN Gang;LIU Wenxin(Department of Pharmacy,Affiliated Tumor Hospital of Nantong University,Nantong,Jiangsu,226361,China;Department of Pharmacy,Beijing Chaoyang Hospital,Capital Medical University,Beijing,100020,China;Department of Emergency,Beijing Chaoyang Hospital,Capital Medical University)
出处
《临床急诊杂志》
CAS
2020年第2期115-119,共5页
Journal of Clinical Emergency
基金
南通市科技计划项目(No:MSZ19073)
南通市药学会一常州四药医院药学科研基金项目(No:ntyx1905).
关键词
社区获得性肺炎
低蛋白血症
危险因素
Community acquired pneumonia
Hypoproteinemia
Risk factors
