期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

社区获得性肺炎患者血清总皮质醇检测的临床价值 被引量：4

下载PDF
导出
摘要 目的探讨血清总皮质醇检测对社区获得性肺炎(CAP)患者病情严重程度及预后评估的价值。方法对78例确诊的CAP患者进行前瞻性研究,根据Fine危险分层将CAP患者分成两组:普通CAP组(n=48)和重症CAP组(n=30)。采用化学发光免疫法测定血清总皮质醇水平。统计分析各组血清总皮质醇水平的差异,血清总皮质醇与肺炎严重度指数(PSI)的相关性,以及PSI评分、血清总皮质醇、C反应蛋白(CRP)及白细胞总数的预后评估价值,进行ROC曲线分析。结果血清总皮质醇水平与PSI之间存在较强的正相关(r=0.742,P<0.001)。重症CAP组与普通CAP组比较[(306.86±79.32)μg/L比(164.61±73.25)μg/L],治疗失败患者与治疗成功患者比较[(341.19±100.90)比(211.62±97.91)μg/L],血清总皮质醇水平明显升高,差异均有统计学意义(P均<0.01)。血清总皮质醇的预测准确度同PSI评分较接近,优于CRP及白细胞总数。结论血清总皮质醇检测能较好预测轻、重CAP患者,血清总皮质醇越高,病情越严重,预后越差。
作者 周宗爱 张霖 周昌盛 梁艳 薛盛东 蔡跃林
机构地区 苍南县人民医院呼吸内科ICU
出处 《中国呼吸与危重监护杂志》 CAS 2010年第2期193-195,共3页 Chinese Journal of Respiratory and Critical Care Medicine
关键词 社区获得性肺炎 总皮质醇 肺炎严重度指数 预后因素
分类号 R563.1 [医药卫生—呼吸系统] R734.2 [医药卫生—肿瘤]
  • 相关文献

参考文献9

  • 1许丽,李春盛.全身炎症反应综合征患者血甲状腺激素和皮质醇水平的变化[J].中华全科医师杂志,2006,5(10):625-626. 被引量：5
  • 2李旭,章志丹,朱然,马晓春.危重症患者血清甲状腺激素及皮质醇水平的变化研究[J].中华外科杂志,2006,44(17):1203-1205. 被引量：15
  • 3中华医学会呼吸分会.社区获得性肺炎诊断与治疗指南[J].中华结核和呼吸杂志,2006,29(10):199-200.
  • 4Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med, 1997,336:243-250.
  • 5Schuetz P, Muller B. The hypothalamic-pituitary-adrenal axis in critical illness. Endocrinol Metab Clin North Am,2006,35:823-838.
  • 6Hamrahian AH, Oseni TS, Arafah BM. Measurements of serum free cortisol in critically ill patients. N Engl J Med,2004, 350: 1629- 1638.
  • 7Almirall J, Bolibar I,Toran P, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest,2004,125:1335-1342.
  • 8Weissman C. The metabolic response to stress: an overview and update. Anesthesiology, 1990,73:308-327.
  • 9Christ-Crain M, Stolz D,Jutla S, et al. Free and Total Cortisol Levels as Predictors of Severity and Outcome in Community-acquired Pneumonia. Am J Respir Crit Care Med,2007,176:913-920.

二级参考文献10

  • 1Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovation therapies in sepsis.American Colleges of Chest Physician/Society of Critical Care Medicine Consensus Conference.Chest,1992,101:1644-1655.
  • 2Knaus WA,Draper EA,Wagner DP,et al.APACHE Ⅱ:a severity of disease classification system.Crit Care Med,1985,13:818-829.
  • 3Marshall JC,Cook D,Christon NV,et al.Multiple Organ Dysfunction Score:a reliable descriptor of a complex clinical outcome.Crit Care Med,1995,23:1638-1652.
  • 4Arem R,Thomby.JI,Deppe SA.Comparison of thyroid hormone and cortisol measurement with APACHE Ⅱ and TISS scoring systems as predictors of mortality in the medical intensive care unit.J Intensive Care Med,1997,12:12-17.
  • 5Umpierrez GE.Euthyroid sick syndrome.South Med J,2002,95:506-513.
  • 6Van den Berghe G.The neuroendocrine response to stress is a dynamic process.Best Proct Res Chh Endocrinol Metab,2001,15:405-419.
  • 7朱钦霞,肖洒,龙仕居,吴乾仔,张泽灵,梁宁,张玉娟.危重患者应激激素和血糖水平的变化[J].中国危重病急救医学,1998,10(8):497-500. 被引量：41
  • 8李春盛,李爱民,田菇敏,刘青斐.老年危重病患者血清甲状腺激素、皮质醇浓度与预后关系[J].急诊医学,1999,8(6):392-394. 被引量：13
  • 9姜志荣,陈志周,尹占莉,陆兴熠,解祥军,王晏平,牛平光.充血性心力衰竭患者甲状腺激素的变化[J].临床荟萃,1992,7(10):441-442. 被引量：13
  • 10Wen-Kui Yu Wei-Qin Li Ning Li Jie-Shou Li, Medical College of Nanjing University, Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China.Influence of acute hyperglycemia in human sepsis on inflammatory cytokine and counterregulatory hormone concentrations[J].World Journal of Gastroenterology,2003,9(8):1824-1827. 被引量：19

共引文献30

同被引文献49

  • 1社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651-655. 被引量：3056
  • 2Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Disea- ses Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults[ J]. Clin Infect Dis 2007, 44 Suppl 2:S27 -72.
  • 3Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identi- fy low-risk patients with community-acquired pneumonia [ J ]. N Engl J Med 1997, 336(4) :243 -250.
  • 4Sligl WI, Marrie TJ. Severe community-acquired pneumonia [ J ]. Crit Care Clin 2013, 29(3) :563 -601.
  • 5Cheng M, Yang J, Gao YD, et al. Corticosteroid therapy for se- vere community-acquired pneumonia: a meta-analysis-reply [ J ]. Respir Care 2014, 59(8) :e118 - 119.
  • 6Nguyen DN, Huyghens L, Zhang H,et al. Cortisol is an associat- ed-risk factor of brain dysfunction in patients with severe sepsis and septic shock[ J]. Biomed Res Int 2014, 2014:712742.
  • 7Kolditz M, Hoffken G, Martus P, et al. Serum cortisol predicts death and critical disease independently of CRB-65 score in com- munity-acquired pneumonia: a prospective observational cohort study[J]. BMC Infect Dis 2012, 12:90.
  • 8Christ-Crain M, Stolz D, Jutla S, et al : Free and total cortisol lev- els as predictors of severity and outcome in community-acquired pneumonia[ J]. Am J Respir Crit Care Med 2007, 176(9) :913 - 920.
  • 9麦热哈巴·哈力克,艾尔肯江·孜帕尔,阿地力江·艾合买提.支气管哮喘大鼠模型中IL-1β、IL-6、TNF-α作用机制研究[J].医学信息,2013,26(9):56-57.
  • 10高凤莉,陈伟,鲁重美.肿瘤患者的营养不良状况及其相关因素研究进展[J].中国肿瘤临床与康复,2008,15(1):80-82. 被引量：44

引证文献4

二级引证文献7

中国呼吸与危重监护杂志
2010年 第2期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部