监测血清胱抑素C在老年社区获得性肺炎治疗中的临床价值

Clinical value of serum Cystatin C monitoring in the treatment of community acquired pneumonia in the elderly

中文关键词: 老年  社区获得性肺炎  胱抑素C  β2微球蛋白  肾功能损害

英文关键词: Elderly  Community acquired pneumonia (CAP)  Serum cystatin C (Cys-C)  β2-microglobulin (β2-MG)  Renal lesion

中文摘要:

      目的 探讨血清胱抑素C (Cys-C)动态监测在老年社区获得性肺炎(CAP)治疗中的临床价值.方法 纳入我院呼吸科住院80例CAP患者,随机分成胱抑素C(Cys-C)评估组(观察组)及标准指南组(对照组),观察组CURB-65评分系统中肾功能指标依据Cys-C进行评判并指导治疗,动态比较两组病情转归、感染指标、血清Cys-C、尿素氮(BUN)、肌酐(Cr)及尿β2微球蛋白(β2-MG)等指标,并且评估Cys-C指导下的抗菌素使用情况、住院费用和时间等指标.结果 与对照组比较,观察组血清Cys-C于第7天及第14天均低于对照组(P＜0.01);研究终点时观察组β2-MG、BUN和Cr均低于对照组(P＜0.01),观察组患者住院时间、住院费用和抗菌素使用的时间均低于对照组,差异有统计学意义(P＜0.01).结论 在遵循CAP指南基础上,动态监测血清Cys-C并联合β2-MG,有利于早期发现老年CAP患者肾损害、合理使用抗菌素、缩短病程及降低住院费用.

英文摘要:

      Objective To explore the clinical value of dynamically monitoring serum cystatin C (Cys-C) in the treatment of community acquired pneumonia (CAP) in the elderly.Methods 81 hospitalized patients with CAP were enrolled in the study and were randomly dividedto 2 groups:observation group and control group;the renal function index m CURB-65 score of the patients in observation group was assessed by Cys-C while that of the patients in control group was assessed by blood uria nitroge (BUN);Cys-C guided treatment was applied to patients in observation group;the clinical outcome,infection indices,serum Cys-C,BUN,urea nitrogen (Cr) and β2-microglobulin (β2-MG) of the patients in the 2 groups were dynamically monitored and compared;Cys-C guided apllication of antibiotics,hospitalization cost and duration were estimated.Results The levels of Cys-C of the patients in observation group on the 7th day and the 14th day were lower than those of the patients in control group (P ＜ 0.01);at the end of the study,the levels of β2-MG,BUN and Cr of the patients in observation group were all lower than those of the patients m control group,as well as the hospitalization duration and cost,the time length of antibiotics application,the difference was of statistical significance (P＜0.01).Conclusions Dynamically monitoring serum Cys-C plus β2-MG detection is of help to find the renal lesion in elderly patients with CAP,to make a reasonable application of antibiotics and to shorten the disease course and to cut down the hospitalization cost.???