The effects of serum C-reactive protein, B-natriuretic peptide and cholinesterase on prognosis in elderly patients with pulmonary infection
10.3969/j.issn.1008-9691.2015.04.011
- VernacularTitle:老年肺部感染患者C-反应蛋白及B型钠尿肽和胆碱酯酶水平对预后的影响
- Author:
Zhancong NIU
;
Junxiao LIU
;
Shengjun YANG
;
Yanxia WANG
;
Hongying LIU
- Publication Type:Journal Article
- Keywords:
Elderly pulmonary infection;
C-reactive protein;
B-natriuretic peptide;
Cholinesterase;
Prognosis
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;(4):378-381
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of levels of serum C-reactive protein (CRP), B-natriuretic peptide (BNP) and cholinesterase (ChE) on prognosis of elderly patients with pulmonary infection.Methods Sixty cases aged ≥ 65 years old with lung infection admitted to Departments of Infectious Diseases and Respiration of Hebei Provincial People's Hospital from March 2012 to March 2014 were enrolled. According to the diagnostic criteria of pulmonary infection and the severity score (PSI) of pneumonia, the patients were classified into three groups with different grades of infectious severity (PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups), 20 cases in each group; in the same period, 20 elderly healthy people having accepted the physical examination in this hospital were designed as the healthy control group. Furthermore, according to the difference in prognosis, the patients were divided into a survival group (52 cases) and a death group (8 cases). The PSI scores, the levels of white blood cell count (WBC), D-Dimer, CRP, BNP and ChE, mortalities, times of stay in hospital were compared between the PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups and the healthy control group as well as between the survival and death groups.Results The periods of stay in hospital of patients with PSI Ⅳ and Ⅴ were much longer than that patients with PSI Ⅰ-Ⅲ (days: 14.7±2.1, 18.3±2.6 vs. 9.2±1.7, both P < 0.05), the degree of increase in time in the PSI Ⅴ group being the most significant. Before treatment, compared with the healthy control group, the PSI score, the levels of WBC, D-dimer, CRP and BNP were significantly increased, the level of ChE was markedly decreased in patients with PSI Ⅱ-Ⅲ, Ⅳ and Ⅴ groups, and along with the rise of PSI score the changes were more remarkable [PSI score: 78.9±13.7, 117.4±20.2, 152.1±34.8 vs. 51.3±7.9; WBC (×109/L): 11.4±1.4, 13.6±1.9, 16.7±2.2 vs. 8.9±1.1; D-Dimer (μg/L): 779.6±46.1, 1 068.2±142.6, 1 846.2±215.0 vs.348.3±31.8; CRP (mg/L): 30.1±3.7, 58.2±6.7, 74.7±9.2 vs. 6.8±0.9; BNP (ng/L): 1 057.4±205.1, 1 976.7±333.7, 2 437.7±468.9 vs. 115.8±21.7; ChE (U/L): 6 260±826, 3 390±437, 1 861±268 vs. 7 804±904, allP < 0.05]. The mortalities of groups PSI Ⅳ and PSI Ⅴwere more than that in group PSI Ⅱ - Ⅲ [10.0% (2/20), 30.0% (6/20) vs. 0]; there was no statistically significant difference in age between the survival group and death group (P > 0.05). Compared with the survival group, the PSI score, the levels of WBC, D-dimer, CRP and BNP after treatment in death group were markedly higher [PSI score: 141.5±23.3 vs. 97.6±18.2; WBC (×109/L): 15.9±1.9 vs. 12.1±1.8; D-Dimer (μg/L): 1 373.9±179.4 vs. 627.4±69.6; CRP (mg/L): 69.8±9.8 vs. 42.6±7.3; BNP (ng/L): 2 745.6±374.9 vs. 1 022.2±171.3; allP < 0.05], the level of ChE was significantly lower (U/L: 2 569±309 vs. 5 692±777,P < 0.05).Conclusion The serum levels of CRP, BNP and ChE in aged patients with pulmonary infection are helpful to the early diagnosis of disease severity, so as they have guiding significance in predicting prognosis.
