老年重症肺炎患者血清内脂素变化的临床意义

目的探讨老年重症肺炎患者血清内脂素水平变化的临床意义。方法采用前瞻性研究，选择老年重症肺炎患者59例，老年非重症肺炎患者77例，及30例健康老年体检者作对照组。检测三组血清内脂素、TNF—α、CRP、白细胞介素6（IL-6）、白细胞介素8（IL-8）。老年重症肺炎和非重症肺炎组进行血气分析、APACHEⅡ评分。结果与对照组比较，老年重症肺炎组内脂素高于非重症肺炎组及对照组（P均〈0．01），非重症肺炎组内脂素亦高于对照组（P〈0．01）。老年重症肺炎组中内脂素水平与TNF—α、CRP、IL-6、IL-8呈正相关俨〈0．05），与PaO2、氧合指数呈负相关俨〈0．05）。结论老年重症肺炎患者血清内脂素升高，提示内脂素可能是一种促炎脂肪细胞因子，对于重症肺炎病情严重程度的判断具有一定的临床意义。

Clinical significance ofvisfatin in elderly patient with severe pneumonia

Objective To evaluate the value of the plasma visfatin levels in elderly patients with severe pneumonia. Methods The data of 59 elderly patients with severe pneumonia and 77 elderly patients with non-severe pneumonia as well as 30 elderly healthy individuals were analyzed, prospectively. The plasma levels ofvisfatin, TNF-α, CRP, IL-6, IL-8 were assayed. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ （ APACHE Ⅱ ） were carried out in patients with pneumonia. Results The plasma levels of visfatin in the severe pneumonia group were significantly higher than those in the non-severe pneumonia group and the control group （P〈0.01, respectively ）. The plasma levels of visfatin in non-severe pneumonia group were also higher than those in control （P〈0.05）. The plasma level of visfatin was positively correlated with TNF-α, CRP, IL-6 and IL-8 （/9〈0.05）, while negatively correlated with PaO2 and oxy- genation index （P〈0.05）. Conclusions Serum level of visfatin increases in elderly patients with severe pneumonia. Visfatin may be an important proinflammatory adipocytokine and is valuable in assessing the severity of pneumonia.