老年肺部感染患者脂联素水平的变化及其意义

目的：探讨老年肺部感染患者血清脂联素（APN）水平变化及其与C-反应蛋白（CRP）之间的关系，以期为老年肺部感染患者临床诊断及病情监测提供依据。方法选取2012年1月至2013年6月武警总医院肺部感染患者70例，其中重症肺部感染30例，轻症肺部感染40例；同时选取老年体检者40例为对照组。应用酶联免疫吸附法测定APN水平，免疫比浊法测定CRP，观察上述指标变化。结果与对照组比较，轻症肺部感染组、重症肺部感染组血清APN水平均明显降低[（8.89±1.93），（6.79±1.87） vs （4.89±1.13）mg/L；P＜0.05]，CRD水平明显升高[（1.69±1.12），（13.87±2.72） vs （25.73±5.77）mg/L；P＜0.05]。肺部感染组APN水平与CRP呈负相关（r＝-0.35；P＜0.05）。logistic回归分析结果显示，APN（OR＝0.350，95%CI 0.225-0.544；P＜0.05），空腹血糖（OR＝3.939，95%CI 1.066-14.552；P＜0.05），年龄（OR＝0.870，95%CI 0.781-0.969；P＜0.05）与老年肺部感染有关。结论 APN水平在老年肺部感染患者显著降低，可能是一个新的抗炎因子，可作为老年肺部感染诊断和病情监测的新的标志物。

Change of adiponectin levels in elderly patients with pulmonary infection and its significance

Objective To investigate the changes of serum adiponectin （APN） level in the elderly patients with pulmonary infection and its relationship with C-reactive protein （CRP）, in order to provide basis for clinical diagnosis and disease monitoring for these elderly patients. Methods A total of 70 elderly patients with pulmonary infection admitted in our hospital from January 2012 to June 2013 were enrolled in this study. They were divided into severe pulmonary infection group （n=30） and mild pulmonary infection group （n=40）. Another 40 elderly receiving physical examination in the same period served as controls. ELISA and immune turbidimetry were used to detect the serum levels of APN and CRP respectively. Results The serum levels of APN were significantly lower in the mild and severe pulmonary infection groups than in the controls [（6.79±1.87） and （4.89±1.13） vs （8.89± 1.93）mg/L;P〈0.05], but that of CRP was significantly increased [（13.87±2.72） and （25.73±5.77） vs （1.69±1.12）mg/L;P〈0.05]. A negative correlation was found between the serum levels of CRP and APN in the elderly patients with pulmonary infection （r=-0.350;P〈0.05）. Logistic regression analysis showed that APN （OR=0.350, 95%CI 0.225-0.544;P〈0.05）, fasting blood glucose （OR=3.939, 95%CI 1.066-14.552;P〈0.05）, and age （OR=0.870, 95%CI 0.781-0.969;P〈0.05） were correlated with pulmonary infection in the elderly. Conclusion Serum level of APN is decreased significantly in the elderly patients with pulmonary infection. It may be a new anti-inflammatory factor, and can be used as a new marker for diagnosis and disease monitoring of pulmonary infection in the elderly.