摘要
目的探讨血清胰石蛋白(PSP/reg)在呼吸机相关性肺炎(VAP)诊断和疾病评估中的意义。方法收集该院中心ICU从2012年9月至2015年10月行呼吸机治疗患者的临床资料,在上呼吸机时、确诊VAP第1、4、7、14天及停呼吸机时分别留取血标本,采用酶联免疫吸附测定法(ELISA)检测PSP/reg的浓度,同时记录呼吸机治疗时间,VAP的转归。另选取同期上呼吸机未发生VAP的患者作为对照组。结果与对照组相比,未发生VAP时,VAP组血清PSP/reg浓度比较差异无统计学意义(P>0.05)。从连续监测来看,VAP组发生VAP后,与上呼吸机时相比,血清PSP/reg浓度明显升高,差异有统计学意义(P<0.05),且第4天达到最高峰。第7天血清PSP/reg浓度已明显下降,但仍高于第1天,差异有统计学意义(P<0.05)。第14天血清PSP/reg浓度进一步下降,但比上呼吸相时相比仍较高,差异有统计学意义(P<0.05)。共成功脱机38例,与PSP/reg最高峰时(第4天)相比,停用呼吸机时浓度已明显下降,差异有统计学意义(P<0.05),接近上呼吸机时的浓度,但两者比较差异有统计学意义(P<0.05),且高于对照组脱呼吸机时PSP/reg浓度,差异有统计学意义(P<0.05)。经Spearman分析发现确诊为VAP的第1天,PSP/reg浓度与C反应蛋白(CRP)具有明显相关性(r=0.570,P<0.05),而与白细胞总数(WBC)和降钙素原(PCT)无相关性(P>0.05)。结论 PSP/reg可作为诊断VAP的指标之一,并可能与VAP的严重程度有关。
Objective To investigate the diagnosis and disease assessment of serum pancreatic stone protein（PSP/reg） in venti-lator-associated pneumoniaCVAP） by a prospective study. Methods T h e blood sample was collected in patients with mechanical ventilation（MV） from September 2012 to October 2015. Then the concentration of PSP/reg was detected by ELISA method and the time of MV and the outcome of VAP were recorded, while the patients who did not have VAP occurred in the same period regarded as control group. Results Compared with the control group,there was no significant difference in the serum concentration of PSP/ reg in VAP group（P〉0. 05）. From continuous monitoring,compared with the start time of MV,there was a significant increase in the concentration of PSP/reg in VAP group（P〈0. 05） ,and reached the highest peak in the fourth day. That of the seventh day w a s significantly decreased,but still higher than the first day（P〈0 . 05）. It decreased further in the fourteenth day,but comp ared to the start time of MV was still higher（P〈0. 05）. In this study,38 cases were successfully evacuated in VAP group. Compared with the fourth day,the concentration of PSP/reg in the 38 cases in the stop of MV had significantly decreased（P〈0 . 05） ,close to that of in the start of MV, but still a difference between them（P〈0. 05 ） , and higher than that of the control group in the stop of MV（ P〈 0. 05）. By Spearman analysis, we found that PSP/reg concentration in the first day had a significant correlation with CRP（r = 0. 570, P 〈0. 05）,but WBC and PCT were not（P〉0. 05）. Conclusion PSP/reg can be used as one of the indicators for diagnosis ofVAP,and may be related to the severity of VAP.
出处
《国际检验医学杂志》
CAS
2017年第12期1589-1590,1593,共3页
International Journal of Laboratory Medicine
基金
广东省自然科学基金资助项目(10151401501000001)
广东省中山市科技计划项目(20122A110)
关键词
机械通气
呼吸机相关性肺炎
胰石蛋白
转归
mechanical ventilation
ventilator-associated pneumonia
pancreatic stone protein
prognosis
