血清CRP/ALB对纤支镜下肺泡灌洗治疗难治性肺炎疗效的预测价值

目的 分析血清C-反应蛋白(CRP)/白蛋白(ALB)比值对纤维支气管镜(纤支镜)下肺泡灌洗治疗难治性肺炎疗效的预测价值.方法 收集2016年1月至8月于医院行纤支镜下肺泡灌洗治疗126例难治性肺炎患者的临床资料,所有患者入院后均测定CRP、ALB水平,分析CRP、ALB及CRP/ALB比值与难治性肺炎疗效的关系.结果 无效组CRP、CRP/ALB高于有效组,ALB低于有效组,比较差异有统计学意义(P＜0.05);治疗前,无效组CRP高于有效组,ALB低于有效组,CRP/ALB比值高于有效组(P＜0.05),治疗1周,有效组CRP、CRP/ALB比值降低(P＜0.05),无效组CRP上升,ALB降低,CRP/ALB比值上升,与有效组比较差异有统计学意义(P ＜0.05);CRP、CRP/ALB比值均为影响难治性肺炎纤支镜下肺泡灌洗治疗效果的独立危险因素,其中CRP/ALB比值相关度最高(P＜0.05).结论 血清CRP、CRP/ALB比值均为影响纤支镜肺泡灌洗治疗难治性肺炎治疗效果的重要因素,两者表达增加预示疗效不佳.

Value of Serum CRP/ALB in Predicting the Curative Effect of Bronchoalveolar Lavage Under Fiberoptic Bronchoscopy in the Treatment of Refractory Pneumonia

Objective To evaluate the value of serum C reactive protein (CRP)/ albumin (ALB)ratio in predicting the curative effect of bronchoalveolar lavage under fiberoptic bronchoscopy in the treatment of refractory pneumonia.Methods The clinical data of 126 patients with refractory pneumonia treated by bronchoalveolar lavage under fiberoptic bronchoscopy in the hospital from January 2016 to August 2016 were collected.Levels of CRP and ALB in all patients were determined after admission,and the relationships among CRP,ALB,CRP/ALB and the curative effect on refractory pneumonia were analyzed.Results The level of CRP and CRP/ALB in the ineffective group were higher than those in the effective group while ALB was lower than that in the effective group (P ＜ 0.05).Before the treatment,the level of CRP and CRP/ALB ratio in the ineffective group were higher than those in the effective group,while ALB was lower than that in the effective group (P ＜ 0.05).After 1 week of treatment,the level of CRP and CRP/ALB ratio decreased in the effective group (P ＜ 0.05),and CRP and CRP/ALB ratio increased while ALB decreased in the ineffective group (P ＜ 0.05).The level of CRP and CRP/ALB ratio were the independent risk factors of the curative effect of bronchoalveolar lavage under fiberoptic bronchoscopy in the treatment of refractory pneumonia,and the correlation with CRP/ALB was the highest (P ＜ 0.05).Conclusion Serum CRP level and CRP/ALB ratio are important factors influencing the curative effect of bronchoalveolar lavage under fiberoptic bronchoscopy in the treatment of refractory pneumonia.