血清脂蛋白胆固醇水平降低是需要入住重症监护病房的重症社区获得性肺炎患者的不良预后因素。

Decreased serum level of lipoprotein cholesterol is a poor prognostic factor for patients with severe community-acquired pneumonia that required intensive care unit admission.

作者信息

Chien Yu-Fen, Chen Chung-Yu, Hsu Chia-Lin, Chen Kuan-Yu, Yu Chong-Jen

机构信息

Department of Laboratory Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

J Crit Care. 2015 Jun;30(3):506-10. doi: 10.1016/j.jcrc.2015.01.001. Epub 2015 Jan 8.

DOI:10.1016/j.jcrc.2015.01.001

PMID:25702844

Abstract

PURPOSE

The purpose of this study is to investigate the prognostic values of the serum levels of lipids in patients with severe community-acquired pneumonia (CAP) that required intensive care unit (ICU) admission.

MATERIALS AND METHODS

Patients who had severe CAP that required ICU admission were included. Serum lipid level was collected on the days 1 and 7 of ICU stay. Clinical outcome, including length of ICU stay, hospital stay, and death, were monitored prospectively.

RESULTS

A total of 40 patients were enrolled in this study. Lower high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were found in nonsurvival group on ICU admission day 7 (survivors vs nonsurvivors; mean HDL, 41.8 vs 13.0 mg/dL, P = .002; LDL, 62.3 vs 30.3 mg/dL, P = 0.006, respectively). High-density lipoprotein cholesterol level of less than or equal to 17 mg/dL on day 7 (odds ratio, 1.23) and LDL cholesterol level of less than or equal to 21 mg/dL on day 7 (odds ratio, 1.10) could be a predictor of hospital mortality. The mean change in levels of HDL cholesterol in nonsurvivors decreased significantly than those in survivors from days 1 to 7 (8.5 vs -17.4 mg/dL, P = .04) but not LDL cholesterol.

CONCLUSIONS

Decreased serum HDL cholesterol level from days 1 to 7 may be of prognostic value.

摘要

目的

本研究旨在探讨需要入住重症监护病房（ICU）的重症社区获得性肺炎（CAP）患者血清脂质水平的预后价值。

材料与方法

纳入需要入住ICU的重症CAP患者。在入住ICU的第1天和第7天采集血清脂质水平。前瞻性监测临床结局，包括ICU住院时间、住院时间和死亡情况。

结果

本研究共纳入40例患者。在入住ICU第7天时，非存活组的高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平较低（存活者与非存活者；平均HDL，41.8 vs 13.0 mg/dL，P = 0.002；LDL，62.3 vs 30.3 mg/dL，P = 0.006）。第7天高密度脂蛋白胆固醇水平小于或等于17 mg/dL（比值比，1.23）和第7天低密度脂蛋白胆固醇水平小于或等于21 mg/dL（比值比，1.10）可能是医院死亡率的预测指标。从第1天到第7天，非存活者的HDL胆固醇水平平均变化显著低于存活者（8.5 vs -17.4 mg/dL，P = 0.04），但LDL胆固醇水平没有显著差异。