范路梅 魏红

【摘要】 目的：探究血清D-D、心肌标志物及NAG/Cr与重症肺炎并发脓毒症患者严重程度的关系。方法：选取2017年1月-2020年9月本院收治的80例重症肺炎并发脓毒症患者为观察组，同时期的80例体检健康者为对照组。检测与比较两组的血清D-D、心肌标志物（AST、LDH、CK-MB、cTnI）及NAG/Cr，同时比较观察组中不同SOFA评分及APACHEⅡ评分者的检测结果，采用Spearman秩相关分析血清D-D、心肌标志物及NAG/Cr与重症肺炎并发脓毒症患者SOFA评分及APACHEⅡ评分的关系。结果：观察组的血清D-D、心肌标志物及NAG/Cr均显著高于对照组，观察组中不同SOFA评分及APACHEⅡ评分者的检测结果比较，差异均有统计学意义（P<0.05）。Spearman秩相關分析显示，血清D-D、心肌标志物及NAG/Cr与重症肺炎并发脓毒症患者SOFA评分及APACHEⅡ评分均呈正相关（P<0.05）。结论：血清D-D、心肌标志物及NAG/Cr在重症肺炎并发脓毒症患者中呈现显著异常的状态，且与疾病的严重程度密切相关，因此上述指标在重症肺炎并发脓毒症患者中的检测价值较高。

【关键词】 血清 D-D 心肌标志物 NAG/Cr 重症肺炎 脓毒症 严重程度

[Abstract] Objective： To investigate the relationship between serum D-D， myocardial markers， NAG/Cr and severity degree of severe pneumonia complicated with sepsis. Method： A total of 80 patients with severe pneumonia complicated with sepsis admitted to our hospital from January 2017 to September 2020 were selected as the observation group， and 80 healthy subjects during the same period were selected as the control group. Serum D-D， myocardial markers （AST， LDH， CK-MB and cTnI） and NAG/Cr were detected and compared between two groups， and the detection results of different SOFA scores and APACHEⅡ scores in the observation group were compared. Spearman rank correlation was used to analyze the relationship between serum D-D， myocardial markers， NAG/Cr and SOFA score， APACHE Ⅱ score in patients with severe pneumonia complicated with sepsis. Result： The levels of serum D-D， myocardial markers and NAG/Cr in the observation group were significantly higher than those in the control group， there were significant differences in the detection results of different SOFA scores and APACHE Ⅱ scores in the observation group （P<0.05）. Spearman rank correlation analysis showed that serum D-D， myocardial markers and NAG/Cr were positively correlated with SOFA score and APACHE Ⅱ score in patients with severe pneumonia complicated with sepsis （P<0.05）. Conclusion： Serum D-D， myocardial markers and NAG/Cr are significantly abnormal in patients with severe pneumonia complicated with sepsis， and are closely related to the severity of the disease. Therefore， the detection value of these indicators in patients with severe pneumonia complicated with sepsis were high.

[Key words] Serum D-D Myocardial markers NAG/Cr Severe pneumonia Sepsis Severity degree

First-authors address： Central Hospital of Longhua District， Shenzhen 518110， China

doi：10.3969/j.issn.1674-4985.2021.09.017

重症肺炎的临床危害极大，具有较高的死亡率，而重症肺炎是脓毒症的常见病因之一，因此重症肺炎并发脓毒症在临床并不乏见，而此类情况的存在进一步提高了患者的死亡率，因此对重症肺炎并发脓毒症患者进行严重程度的评估需求较高[1-2]。临床中与重症肺炎及脓毒症相关的研究多见，其中血液及尿液指标在本类患者中的研究虽可见，但是存在研究不足及细致程度欠缺的情况。而D-D、心肌标志物及NAG/Cr等指标作为在肺炎、脓毒症等中均可见的指标[3-5]，其在重症肺炎并发脓毒症患者严重程度中的检测研究相对不足。因此，本研究就血清D-D、心肌标志物及NAG/Cr与重症肺炎并发脓毒症患者严重程度的关系进行细致探究，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月-2020年9月本院收治的80例重症肺炎并发脓毒症患者为观察组，同时期的80例体检健康者为對照组。……