中老年多发性脑梗死合并肺炎患者血小板参数及炎症指标分析
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摘要
目的探讨血小板五项参数及炎症指标表达水平对诊断中老年多发性脑梗死合并肺炎患者的意义,为临床提供相关依据。方法选择2016年8月-2018年8月在医院治疗的中老年多发性脑梗死患者200例为研究对象,依据患者是否发生肺炎,将患者分为肺炎组与无肺炎组,其中肺炎组患者75例,无肺炎组患者125例,另选择同期在医院进行健康体检的100例健康者设置为健康组。检测两组研究者的血小板参数与炎症指标表达水平,并对结果进行比较分析。结果肺炎组血小板压积(PCT)与血小板计数(PLT)明显低于无肺炎组和健康组,肺炎组患者血小板分布宽度(PDW)、大血小板比率(P-LCR)、平均血小板体积(MPV)、血清超敏C-反应蛋白(HS-CRP)、白细胞介素18(IL-18)以及淀粉样蛋白A(SAA)显著高于无肺炎组和健康组,差异有统计学意义(P<0.05)。结论中老年多发性脑梗死患者的血小板参数及炎症指标表达水平有显著变化,并且随着肺炎的并发变化会加剧,能够成为监测、评估老年多发性脑梗死合并肺炎患者预后的重要指标。
OBJECTIVE To explore the value of five platelet parameters and inflammatory factors in diagnosis of pneumonia in middle-aged and elderly patients with multiple cerebral infarction. METHODS A total of 200 middle-aged and elderly patients who were treated in hospitals from Aug 2016 to Aug 2018 were recruited as the study objects and divided into the pneumonia group with 75 cases and the no pneumonia group with 125 cases, meanwhile, 100 healthy people who received physical examination were set as the healthy group. The levels of platelet parameters and inflammatory factors were detected, observed and compared. RESULTS The thrombocytocrit(PCT) and platelet counts(PLT) were significantly lower in the pneumonia group than in the no pneumonia group and the healthy group; the platelet distribution width(PDW), platelet-large cell ratio(P-LCR), mean platelet volume(MPV), serum high-sensitivity C-reactive protein(hs-CRP), interleukin-18(IL-18) and serum amyloid A were significantly higher in the pneumonia group than in the no pneumonia group and the healthy group(P<0.05). CONCLUSION The levels of platelet parameters and inflammatory factors vary significantly in the middle-aged and elderly patients with multiple cerebral infarction and may change more remarkably with the concurrent pneumonia, which can serve as important indicators for monitoring and evaluation of prognosis of the middle-aged and elderly multiple cerebral infarction patients complicated with pneumonia.
OBJECTIVE To explore the value of five platelet parameters and inflammatory factors in diagnosis of pneumonia in middle-aged and elderly patients with multiple cerebral infarction. METHODS A total of 200 middle-aged and elderly patients who were treated in hospitals from Aug 2016 to Aug 2018 were recruited as the study objects and divided into the pneumonia group with 75 cases and the no pneumonia group with 125 cases, meanwhile, 100 healthy people who received physical examination were set as the healthy group. The levels of platelet parameters and inflammatory factors were detected, observed and compared. RESULTS The thrombocytocrit(PCT) and platelet counts(PLT) were significantly lower in the pneumonia group than in the no pneumonia group and the healthy group; the platelet distribution width(PDW), platelet-large cell ratio(P-LCR), mean platelet volume(MPV), serum high-sensitivity C-reactive protein(hs-CRP), interleukin-18(IL-18) and serum amyloid A were significantly higher in the pneumonia group than in the no pneumonia group and the healthy group(P<0.05). CONCLUSION The levels of platelet parameters and inflammatory factors vary significantly in the middle-aged and elderly patients with multiple cerebral infarction and may change more remarkably with the concurrent pneumonia, which can serve as important indicators for monitoring and evaluation of prognosis of the middle-aged and elderly multiple cerebral infarction patients complicated with pneumonia.
引文
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[19] 邱楠,郝若飞.血小板5项参数检测对脑梗死和脑出血诊断的应用价值[J].广东医学,2018,39(S2):194-197.
[20] Someya H,Fujiwara H,Nagata K,et al.Thymosin beta 4 is associated with RUNX2 expression through the Smad and Akt signaling pathways in mouse dental epithelial cells[J].Int J Mol Med,2015,35(5):1169-1178.
[21] 戴杰,周永,李新玲,等.影响后循环脑梗死急性期阿司匹林和氯吡格雷联合抗血小板治疗预后的相关因素[J].临床神经病学杂志,2014,27(1):22-25.
[22] 沈明强,程庆璋,石冬敏.不同抗血小板治疗对急性脑梗死患者血小板活化聚集状态的比较[J].南京医科大学学报(自然科学版),2013,33(2):213-216.
[23] 孙姬,徐恒仕.血栓弹力图与血小板指标在脑梗死患者中的相关性研究[J].中国输血杂志,2015,28(8):1037-1039.
[24] Arman M,Krauel K,Tilley DO,et al.Amplification of bacteria-induced platelet activation is triggered by FcγRIIA,integrin αIIbβ3,and platelet factor 4[J].Blood,2014,123(20):3166-3174.
[2] Ulvenstam A,Kajermo U,Modica A,et al.Incidence,trends,and predictors of ischemic stroke 1 year after an acute myocardial infarction[J].Stroke,2014,45(11):3263-3268.
[3] Wu XN,Zhang T,Wang J,et al.Magnetic resonance diffusion tensor imaging following major ozonated autohemotherapy for treatment of acute cerebral infarction[J].Neural Regen Res,2016,11(7):1115-1121.
[4] 朱莉.脑梗死康复期患者肺部感染的相关因素及并发肺部感染对预后的影响[J].中国现代药物应用,2018,12(6):17-19.
[5] Helleberg BH,Ellekjr H,Rohweder G,et al.Mechanisms,predictors and clinical impact of early neurological deterioration:the protocol of the Trondheim early neurological deterioration study[J].BMC Neurol,2014,14:201.
[6] Hou H,Zhang G,Wang H,et al.High matrix metalloproteinase-9 expression induces angiogenesis and basement membranedegradation in stroke-prone spontaneously hypertensive rats after cerebral infarction[J].Neural Regen Res,2014,9(11):1154-1162.
[7] Li J,Meng XM,Li RY,et al.Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction[J].Neural Regen Res,2016,11(10):1584-1590.
[8] 中华医学会神经病学分会脑血管学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2011,39(3):227-233.
[9] 晏宁.急性中重度脑卒中患者继发性肺部感染致病菌分析[A].中华医学会、中华医学会神经病学分会.中华医学会第十七次全国神经病学学术会议论文汇编(上)[C].中华医学会、中华医学会神经病学分会:2014:2.
[10] 韩倩,焦建龙,魏荣伟,等.血清微量元素含量对脑梗死患者肺部感染的预测评价及与红细胞免疫与炎症反应的相关性[J].中华医院感染学杂志,2017,27(15):3449-3452.
[11] 王锦华,陈强,汪东良.老年急性脑梗死患者依达拉奉联合神经节苷脂治疗的临床效果及对炎症因子的影响[J].中华医院感染学杂志,2015,25(10):2179-2181.
[12] Sun CM,Wu J,Zhang H,et al.Circulating miR-125a but not miR-125b is decreased in active disease status and negatively correlates with disease severity as well as inflammatory cytokines in patients with Crohn's disease[J].World J Gastroenterol,2017,23(44):7888-7898.
[13] Hou H,Zhang G,Wang H,et al.High matrix metalloproteinase-9 expression induces angiogenesis and basement membranedegradation in stroke-prone spontaneously hypertensive rats after cerebral infarction[J].Neural Regen Res,2014,9(11):1154-1162.
[14] 沈春子,吴有丽,周霞,等.皮质下缺血性血管病患者平均血小板体积水平变化及其意义[J].安徽医科大学学报,2017,52(2):240-244.
[15] 张作念,王志晔,顾伟,等.急性脑梗死患者血清炎症因子与颈动脉粥样硬化斑块性质关系的临床研究[J].重庆医学,2016,45(10):1375-1377.
[16] Zhang T,Liao JY,Yu L,et al.Regulating effect of glycyrrhetinic acid on bronchial asthma smooth muscle proliferation and apoptosis as well as inflammatory factor expression through ERK1/2 signaling pathway[J].Asian Pac J Trop Med,2017,10(12):1172-1176.
[17] Kumagawa M,Matsumoto N,Watanabe Y,et al.Contrast-enhanced ultrasonographic findings of serum amyloid A-positive hepatocellular neoplasm:does hepatocellular adenoma arise in cirrhotic liver?[J].World J Hepatol,2016,8(26):1110-1115.
[18] Ma CY,Liu JH,Liu JX,et al.Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome[J].Chin J Integr Med,2017,23(11):845-849.
[19] 邱楠,郝若飞.血小板5项参数检测对脑梗死和脑出血诊断的应用价值[J].广东医学,2018,39(S2):194-197.
[20] Someya H,Fujiwara H,Nagata K,et al.Thymosin beta 4 is associated with RUNX2 expression through the Smad and Akt signaling pathways in mouse dental epithelial cells[J].Int J Mol Med,2015,35(5):1169-1178.
[21] 戴杰,周永,李新玲,等.影响后循环脑梗死急性期阿司匹林和氯吡格雷联合抗血小板治疗预后的相关因素[J].临床神经病学杂志,2014,27(1):22-25.
[22] 沈明强,程庆璋,石冬敏.不同抗血小板治疗对急性脑梗死患者血小板活化聚集状态的比较[J].南京医科大学学报(自然科学版),2013,33(2):213-216.
[23] 孙姬,徐恒仕.血栓弹力图与血小板指标在脑梗死患者中的相关性研究[J].中国输血杂志,2015,28(8):1037-1039.
[24] Arman M,Krauel K,Tilley DO,et al.Amplification of bacteria-induced platelet activation is triggered by FcγRIIA,integrin αIIbβ3,and platelet factor 4[J].Blood,2014,123(20):3166-3174.
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