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目的通过观察重症肺炎患儿不同疾病时期血清中肺表面活性蛋白A(SP-A)的水平,探讨其在判断肺损伤病情程度的临床意义。方法检测正常儿童、普通肺炎及和重症肺炎患儿急性期、恢复期的血清SP-A水平,同时记录氧合指数[动脉血氧分压(PaO2)/吸入氧深度(FiO2)]和小儿危重病例评分(PCIS)并进行比较,并行血清SP-A与PaO2/FiO2及PCIS相关分析。结果重症肺炎患儿急性期组较对照两组血清中SP-A水平升高,而PaO2/FiO2和PCIS值下降(P均<0.05),恢复期与对照两组间比较差异无统计学意义(P>0.05);血清SP-A水平与氧合指数及PCIS评分的相关系数分别为0.615和0.573(P均<0.05)。结论重症肺炎患儿急性期血清SP-A的水平反映肺损伤病情严重程度,或可作为创伤较小的临床检测指标。
Objective To investigate the clinical significance of serum SP-A level in patients with severe pneumonia at different stages of disease and to determine the severity of lung injury. Methods Serum levels of SP-A in normal children, children with common pneumonia and children with severe pneumonia were measured at the same time. The oxygenation index (PaO2 / FiO2) and pediatric critically ill Case score (PCIS) and compared, parallel analysis of serum SP-A and PaO2 / FiO2 and PCIS. Results Serum levels of SP-A in patients with severe pneumonia were significantly higher than those in control group, but PaO2 / FiO2 and PCIS values were decreased in both acute phase group and control group (P <0.05). There was no significant difference between the two groups P> 0.05). The correlation coefficients of serum SP-A level with oxygenation index and PCIS score were 0.615 and 0.573, respectively (all P <0.05). Conclusion The level of serum SP-A in children with severe pneumonia in acute stage reflects the severity of lung injury or may be used as a clinical indicator of less trauma.