低磷血症对老年社区获得性肺炎患者近期预后的影响
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摘要
目的探讨低磷血症对老年社区获得性肺炎(CAP)患者近期预后的影响。方法选取2013年1月~2014年8月惠州仲恺高新区人民医院收治112例老年CAP患者为研究对象,根据是否伴有低磷血症分为两组,其中,低磷血症组42例,非低磷血症组70例。检测患者入院24 h内的血气分析、血常规等实验室检查指标,并记录两组患者平均住院时间、抗感染治疗时间、死亡率、肺炎严重程度等指标,进行统计学比较分析。结果低磷血症组患者血钠、白蛋白、PaO_2水平均明显低于非低磷血症组患者,差异有统计学意义(P<0.05);而CRP水平、WBC计数均明显高于非低磷血症组患者,差异有统计学意义(P<0.05);低磷血症组平均住院时间、抗感染治疗时间、APACHEⅡ评分、死亡率、重症肺炎发生率均明显高于非低磷血症组,差异均有统计学意义(均P<0.05)。结论血磷水平与老年CAP患者预后密切相关。
Objective To investigate the influence of hypophosphatemia on the short-term prognosis of elderly patients with community-acquired pneumonia(CAP). Methods A total of 112 elderly patients with CAP treated in People's Hospital of Huizhou Zhongkai Hi-tech Industrial Development Zone from January 2013 to August 2014 were selected.According to whether combined with hypophosphatemia or not, patients were divided into hypophosphatemia group(n=42)and non-hypophosphatemia group(n=70). The indexes of laboratory examination, including blood gas analysis, blood routine examination were detected within 24 hours of hospitalization. The average hospital stay, time of anti-infection treatment, the mortality rate and the severity of pneumonia were recorded. All the data were analyzed statistically. Results The levels of serum sodium, albumin and PaO_2 in patients of the hypophosphatemia group were significantly lower than those of the non-hypophosphatemia group(P < 0.05), while CRP level and WBC were significantly higher than those of the non-hypophosphatemia group(P < 0.05). The average hospital stay, time of anti-infection treatment, APACHEⅡ score, mortality rate and severity of severe pneumonia in the patients of the hypophosphatemia group were significantly higher than those of the non-hypophosphatemia group(P < 0.05). Conclusion The level of serum phosphorus is closely related to the prognosis of elderly patients with CAP.
Objective To investigate the influence of hypophosphatemia on the short-term prognosis of elderly patients with community-acquired pneumonia(CAP). Methods A total of 112 elderly patients with CAP treated in People's Hospital of Huizhou Zhongkai Hi-tech Industrial Development Zone from January 2013 to August 2014 were selected.According to whether combined with hypophosphatemia or not, patients were divided into hypophosphatemia group(n=42)and non-hypophosphatemia group(n=70). The indexes of laboratory examination, including blood gas analysis, blood routine examination were detected within 24 hours of hospitalization. The average hospital stay, time of anti-infection treatment, the mortality rate and the severity of pneumonia were recorded. All the data were analyzed statistically. Results The levels of serum sodium, albumin and PaO_2 in patients of the hypophosphatemia group were significantly lower than those of the non-hypophosphatemia group(P < 0.05), while CRP level and WBC were significantly higher than those of the non-hypophosphatemia group(P < 0.05). The average hospital stay, time of anti-infection treatment, APACHEⅡ score, mortality rate and severity of severe pneumonia in the patients of the hypophosphatemia group were significantly higher than those of the non-hypophosphatemia group(P < 0.05). Conclusion The level of serum phosphorus is closely related to the prognosis of elderly patients with CAP.
引文
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[14]李复红,传锋彬,张亚萍,等.老年社区获得性肺炎137例诊治分析[J].陕西医学杂志,2012,41(9):1125-1126.
[15]蒋贤高,尤荣开.全身炎症反应综合征患者低血磷的临床意义[J].中国危重病急救医学,2000,12(10):623.
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[22]Hosseini H,Masoumpour M,Keshavarz-Fazl F,et al.Clinical and epidemiologic characteristics of severe childhood ocular injuries in soumem Iran[J].Middle East Afr J Ophthalmol,2011,18(2):136-140.
[23]Liu ML,chang YS,Tseng SH,et al.Major pediatric ocular trauma in Taiwan[J].J Pediatr Ophthalmol Strabismus,2010,47(2):88-95.
[24]李秋泉,刘可权,王晓鸣,等.两种左氧氟沙星用药方案治疗社区获得性肺炎的疗效分析[J].中国医药科学,2015,5(6):38-40.
[25]Babar TF,Kha Il MT,Manvat MZ,et al.Pattems of ocular trauma[J].J Coll Physicians Surg Pak,2007,17(3):148-153.
[26]栗彩红.阿奇霉素与左氧氟沙星治疗社区获得性肺炎的临床疗效与药物经济学评价[J].中国医药科学,2015,5(21):107-109.
[2]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,49(12):651-655.
[3]刘桂华,李颖.重症监护病房患者早期低血糖、低磷血症对预后的影响[J].中华临床医师杂志:电子版,2013,11(10):132-134.
[4]Sankaran RT,Mattana J,Pollack S,et al.Laboratory abnormalities in patients with bacterial pneumonia[J].Chest,1997,111(3):595-600.
[5]张利鹏,周丽华,黄志民,等.低磷血症对机械通气病人治疗及预后影响[J].内蒙古医学院学报,2011,33(3):237-238.
[6]袁开芬,赵国厚,张洋.慢性阻塞性肺疾病患者血磷浓度分析[J].中国老年保健医学枠杂志,2014,21(9):321-323.
[7]符加,红臧彬.重症监护病房患者低磷血症的发生及对预后的影响[J].中国危重病急救医学,2012,24(1):29-31.
[8]承韶晖,周树生,王锦权,等.连续性血液净化与危重病患者低磷血症的相关性研究[J].中国急救医学,2011,31(2):125-127.
[9]朱亮,奚耀,钱义明,等.重症监护室危重患者早期血磷水平与预后的相关性分析.临床内科杂志,2011,28(4):267-268.
[10]Ceerse DA,Bindels AJ,Kuiper MA,et al.Treatment of hypophos-phatemia in the intensive care unit:a review[J].Crit Care,2010,14(20):1314-1321.
[11]朱海英,于常英,卢冬喜.早期血磷水平对老年社区获得性肺炎患者预后的影响[J].中国老年学杂志,2012,32(11):2412-2413.
[12]Evenepoel P.Recovery versus persistence of disordered mineral metabolism in kidney transplant recipients[J].Semin Nephrol,2013,33(16):191-203.
[13]于振玲,宁玉辉,张珊.危重症病人低磷血症与其免疫指标的相关性分析[J].青岛大学医学院学报,2014,48(1):76-78.
[14]李复红,传锋彬,张亚萍,等.老年社区获得性肺炎137例诊治分析[J].陕西医学杂志,2012,41(9):1125-1126.
[15]蒋贤高,尤荣开.全身炎症反应综合征患者低血磷的临床意义[J].中国危重病急救医学,2000,12(10):623.
[16]李复红,传锋彬,张亚萍,等.老年社区获得性肺炎137例诊治分析[J].陕西医学杂志,2012,41(9):1125-1126.
[17]Brophy M,sinclair SA,Hostetler SG,et al.Pediatric eye injury·related hospitalizations in the united states[J].Pediatrics,2006,117(6):e1263-e1271.
[18]Kulhl F,Morris R,Witherspoon CD,et al.A standardized classmcation of oculartrama[J].Gmefes Arch Clin Exp ophthalmo I,1996,234:399-403.
[19]Kuhn F,Morris R,Witherspoon CD.Birmingham Eye Trauma Terminology(BETT):terminology and classmca tion of mechanical eye injuries[J].Ophmalmol Clin North Am,2002,15(2):139-143.
[20]Serrano JC,Chalela P,Arias JD.Epidemiology of childhood ocular trauma in a northeastem Colombianregion[J].Arch ophthalmol,2003,121(10):1439-1445.
[21]Mela EK,Georgakopoulos CD,Georgalis A,et al.Severe ocular injuries in Greek children[J].Ophthalmic Epidemiol,2003,10(1):23-29.
[22]Hosseini H,Masoumpour M,Keshavarz-Fazl F,et al.Clinical and epidemiologic characteristics of severe childhood ocular injuries in soumem Iran[J].Middle East Afr J Ophthalmol,2011,18(2):136-140.
[23]Liu ML,chang YS,Tseng SH,et al.Major pediatric ocular trauma in Taiwan[J].J Pediatr Ophthalmol Strabismus,2010,47(2):88-95.
[24]李秋泉,刘可权,王晓鸣,等.两种左氧氟沙星用药方案治疗社区获得性肺炎的疗效分析[J].中国医药科学,2015,5(6):38-40.
[25]Babar TF,Kha Il MT,Manvat MZ,et al.Pattems of ocular trauma[J].J Coll Physicians Surg Pak,2007,17(3):148-153.
[26]栗彩红.阿奇霉素与左氧氟沙星治疗社区获得性肺炎的临床疗效与药物经济学评价[J].中国医药科学,2015,5(21):107-109.