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目的研究肺炎伴全身炎症反应综合征(SIRS)时C反应蛋白及血糖水平的变化及其意义。方法随机选取131例非SIRS肺炎、63例肺炎伴SIRS S1期、44例肺炎伴SIRS S2期,以及37例肺炎伴多器官功能不全综合征(MODS)的住院患者,对比研究血糖及CRP的改变以及治疗前后的变化。另设40例健康者为对照组。结果⑴非SIRS肺炎组血糖处于正常范围,与对照组比较差异无统计学意义;⑵SIRS S1组、SIRS S2组及MODS组血糖明显高于对照组,且各组间差异有统计学意义;⑶各肺炎组CRP均明显高于对照组,MODS组高于SIRS组,SIRS组高于非SIRS组,SIRS组中的S2组高于S1组,各组间差异有统计学意义;⑷经治疗1周后,CRP及血糖在MODS组分别下降了3.7%和11.2%,SIRS S2组下降14.6%和17.3%,SIRS S1组下降33.5%和21.1%,各组间的下降程度存在显著性差异。结论重症肺炎时,CRP及血糖随着病情加重平行升高。CRP及血糖两项指标的联合应用对于预测肺炎是否并发SIRS具有一定的临床意义。
Objective To study the changes of C-reactive protein and blood glucose levels in patients with pneumonia complicated with systemic inflammatory response syndrome (SIRS) and its significance. Methods A total of 131 hospitalized patients with non-SIRS pneumonia, 63 pneumonia with SIRS S1, 44 pneumonia with SIRS S2, and 37 patients with pneumonia complicated with multiple organ dysfunction syndrome (MODS) were randomly selected to study the changes of blood glucose and CRP As well as changes before and after treatment. Another 40 cases of healthy control group. Results (1) The blood glucose in the non-SIRS pneumonia group was in the normal range, there was no significant difference compared with the control group; (2) The blood glucose of the SIRS S1 group, the SIRS S2 group and the MODS group was significantly higher than that of the control group The levels of CRP in pneumonia group were significantly higher than those in control group, the levels in MODS group were higher than those in SIRS group, SIRS group were higher than those in non-SIRS group, S2 group in SIRS group was higher than that in S1 group, and there was significant difference between groups CRP and blood glucose decreased by 3.7% and 11.2% respectively in MODS group, 14.6% and 17.3% in SIRS group S2, and 33.5% and 21.1% in SIRS group S1, respectively. There was a significant difference between the two groups in the degree of decline. Conclusions Severe pneumonia, CRP and blood glucose increased parallel with the exacerbations. The combination of CRP and blood glucose has some clinical significance in predicting whether pneumonia is complicated by SIRS.