【摘要】：目的探討腸黏膜屏障功能在老年重癥慢性阻塞性肺疾病(COPD)患者預(yù)后評估中的臨床意義。方法選取老年COPD合并呼吸衰竭并給予有創(chuàng)機(jī)械通氣患者53例,根據(jù)病情轉(zhuǎn)歸分為存活組35例、死亡組18例;測定給予機(jī)械通氣治療0、72 h的靜脈血D-乳酸、二胺氧化酶(DAO)及急性生理與慢性健康狀況(APACHE)Ⅱ評分。分析腸黏膜屏障功能變化與預(yù)后的關(guān)系。結(jié)果與對照組相比,死亡組與存活組入組時(shí)APACHEⅡ評分、血清D-乳酸、DAO明顯升高(P0.05);入組時(shí)死亡組與存活組比較,APACHEⅡ評分、血清D-乳酸、DAO略有升高,但無統(tǒng)計(jì)學(xué)差異(P0.05);治療72 h后,存活組與死亡組APACHEⅡ評分、血清D-乳酸、DAO都較治療前下降,存活組下降程度更顯著(P0.05)。相關(guān)分析顯示COPD合并呼吸衰竭患者血清D-乳酸、DAO水平與APACHEⅡ評分明顯正相關(guān)。結(jié)論老年重癥COPD患者腸黏膜屏障功能可作為判斷病情嚴(yán)重程度、觀察療效和評估預(yù)后的指標(biāo)之一。
[Abstract]:Objective To study the clinical significance of intestinal mucosal barrier function in the prognosis of elderly patients with severe chronic obstructive pulmonary disease (COPD). Methods 53 patients with COPD combined with respiratory failure were selected, and 53 patients with invasive mechanical ventilation were divided into the survival group (35 cases) and the death group (18 cases) according to the outcome of the disease. The D-lactic acid was measured by mechanical ventilation for 0 and 72 hours. Diamine oxidase (DAO) and acute physiology and chronic health (APACHE) 鈪，

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