实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (8): 794-797.doi: 10.3969/j.issn.1003-9198.2023.08.010

• 临床研究 • 上一篇    下一篇

老年吸入性肺炎支气管肺泡灌洗液的生物学标志物和病原学分析

时铭蔚, 周朝娥, 王立娜, 孙春萍, 李君, 刘新民   

  1. 100034 北京市,北京大学第一医院老年内科
  • 收稿日期:2022-09-18 出版日期:2023-08-20 发布日期:2023-08-28
  • 通讯作者: 刘新民,Email:lxm2128@163.com
  • 基金资助:
    国家重点研发计划项目(2020YFC2005400)

Biomarkers and etiological analysis of the bronchoalveolar lavage fluid in elderly patients with aspiration pneumonia

SHI Ming-wei, ZHOU Chao-e, WANG Li-na, SUN Chun-ping, LI Jun, LIU Xin-min   

  1. Department of Geriatrics, Peking University First Hospital, Beijing 100034, China
  • Received:2022-09-18 Online:2023-08-20 Published:2023-08-28
  • Contact: LIU Xin-min, Email:lxm2128@163.com

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摘要： 目的 探索支气管肺泡灌洗液(bronchoalveolar lavage fluid, BALF)中的淀粉酶和胃蛋白酶辅助诊断老年吸入性肺炎(aspiration pnuemonia, AP)的价值,并分析老年AP病人的病原学特征,为临床诊疗提供思路。 方法 纳入2021年9月至2022年1月北京大学第一医院住院治疗的65名受试者,根据临床诊断将受试者分为AP和非AP(no-AP)2组,检测病人BALF中胃蛋白酶和淀粉酶水平,并分析2组病人BALF中病原学检测结果。 结果 2组病人胃蛋白酶水平差异无统计学意义(P>0.05);AP组淀粉酶水平显著高于no-AP组(878.0 IU/L比88.6 IU/L,P＜0.001)。BALF中淀粉酶预测AP的AUC为0.83。AP组检出的病原体主要为肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和鲍曼不动杆菌。BALF中细菌检测阳性病人的淀粉酶水平显著高于阴性病人(408.9 IU/L比48.4 IU/L,P＜0.001)。 结论 BALF中淀粉酶有助于临床医生及时诊断老年AP病人。

关键词: 吸入性肺炎, 生物标志物, 病原体, 胃蛋白酶, 淀粉酶

Abstract: Objective To explore the value of amylase and pepsin in bronchoalveolar lavage fluid (BALF) in the diagnosis of aspiration pneumonia (AP), and to analyze the etiological characteristics of AP in the elderly patients. Methods A total of 65 subjects admitted to Peking University First Hospital from September 2021 to January 2022 were enrolled and divided into AP group and non-aspiration pneumonia(no-AP) group according to clinical diagnosis. The levels of pepsin and amylase and the pathogenic bacteria in BALF were detected and compared between the two groups. Results There was no significant difference in the level of pepsin between the two groups(P>0.05), but the level of amylase in AP group was significantly higher than that in no-AP group(878.0 IU/L vs 88.6 IU/L, P＜0.001). Receiver operating characteristic (ROC) curve showed that amylase in BALF could predict AP with an area under the curve(AUC) of 0.83. The main pathogens detected in AP group were Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. The level of amylase of BALF in bacteria-positive patients was significantly higher than that in bacteria-negative patients (408.9 IU/L vs 48.4 IU/L,P＜0.001). Conclusions The level of amylase in BALF helps to timely diagnose AP in the elderly patients.

Key words: aspiration pneumonia, biomarkers, pathogens, pepsin, amylase

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