脂蛋白在肺部感染致老年多器官功能不全中的变化

目的 探讨脂蛋白(a)Lp(a)]在肺部感染导致老年多器官功能不全(MODSE)患者的变化规律.方法 选择肺部感染导致MODSE患者100例,正常对照40例,常规临床检查,痰培养,应用胶乳凝集比浊法测定其血清Lp(a)变化.结果 多种病原菌可导致老年人肺部感染并发MODSE;对照组患者血清Lp(a)水平为(103.51±76.04)mg/L,老年器官功能不全患者总体Lp(a)水平为(382.16±260.36)mg/L,在心、肾、消化、泌尿、呼吸、脑功能不全组分别为(351.11±288.78)、(286.28±177.35)、(299.53±189.74)、(370.13±280.13)、(254.26±239.85)、(370.13±280.13)mg/L,较对照组差异均有统计学意义(P＜0.05)；对照组患者Lp(a)异常比例为5.0％,在心、肾、消化、泌尿、呼吸、脑功能不全组分别为61.7％、53.3％、48.5％、60.0％、31.0％、35.3％,较对照组差异均有统计学意义(P＜0.05)；非条件logistic回归分析显示,Lp(a)、维蛋白原、前蛋白水平与MODSE有关.结论脂蛋白(a)参与老年肺部感染导致多器官功能不全病理过程,其水平升高可能是导致多器官功能不全的机制之一.

Changes of lipoprotein in serum of senile patients with multiple organ dysfunction syndrome induced by pulmonary infections

OBJECTIVE To study the potential role of lipoprotein(a) induced by pulmonary infection with multiple organ dysfunction syndrome(MODSE) in senile patients.METHODS The clinical data of 100 cases with pulmonary infections complicated with MODSE were analyzed,the serum levels of Lp(a) were measured by latex agglutination turbidimetric method,and 40 healthy persons were treated as controls.RESULTS Multiple species of pathogenic bacteria resulted in MODSE.The level of Lp(a) were significantly increased in organ dysfunction senile patients compared with the controls(P<0.05),the level of Lp(a) in control serum was 103.51±76.04 mg/L,the level of Lp(a) in MODSE serum was 382.16±260.36 mg/L,the levels of Lp(a) in functional defect of heart,kidney,digestion,urology,respiration,brain were(351.11±288.78),(286.28±177.35),(299.53±189.74),(370.13±280.13),(254.26±239.85),and(370.13±280.13) mg/L.The abnormal ratio was significantly increased in organ dysfunction senile patients compared with the controls(p<0.05),the abnormal ratio in control serum was 5.0%,the abnormal ratios in the functional defects of heart,kidney,digestion,urology,respiration,and brain were 61.7 %,53.3%,48.5%,60.0%,and 31.3 %,respectively,the differences were statistically significant as compared with the control group(P<0.05).Unconditional logistic regression analysis indicated that the levels of Lp(a),fibrinogen,and prealbumin were related to MODSE.CONCLUSION Lipoprotein(a) may involve in the process of multiple organs dysfunction,and its elevated level may be one of the mechanisms that lead to the multiple organ dysfunction.