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目的观察重症肺炎APACHE II评分及血D-乳酸水平的变化,并分析其与疾病严重程度的关系,判断重症肺炎肠黏膜屏障功能的改变。方法选择40例重症肺炎患者(A组),另选择同期25例普通肺炎患者作为B组,健康人群25例作为C组。在患者入组时抽血测D-乳酸水平,测APACHE评分,并对检测结果进行统计学分析。结果重症肺炎组患者D-乳酸水平明显高于普通肺炎组和健康对照组,差异有统计学意义(P=0.011,0.016);普通肺炎组D-乳酸水平高于健康对照组(P=0.034);重症肺炎组患者APACHE II评分与D-乳酸呈线性正相关(【apache评分】=【D-乳酸】*9.753-52.948)。结论重症肺炎患者肠黏膜屏障功能均有不同程度损伤,随病情的加重而损伤程度加重,早期保护肠黏膜屏障功能对改善重症肺炎预后有积极的意义。
Objective To observe the changes of APACHE II score and blood D-lactate level in severe pneumonia and to analyze its relationship with the severity of the disease and to determine the changes of intestinal mucosal barrier function in severe pneumonia. Methods Forty patients with severe pneumonia (group A) were selected. 25 patients with common pneumonia were selected as group B in the same period and 25 healthy people as group C. D-lactate levels were measured by blood sampling, APACHE score, and statistical analysis of test results. Results The level of D-lactate in patients with severe pneumonia was significantly higher than that in patients with pneumonia and healthy controls (P = 0.011,0.016). The level of D-lactate in patients with pneumonia was significantly higher than that in healthy controls (P = 0.034) ; APACHE II score in patients with severe pneumonia was positively correlated with D-lactate ([apache score] = [D-lactate] * 9.753-52.948). Conclusion Intestinal mucosal barrier function in patients with severe pneumonia have different degrees of injury, with the aggravation of the severity of the injury worse, early protection of intestinal mucosal barrier function to improve the prognosis of severe pneumonia have a positive effect.