目的:探讨C反应蛋白(C-reactive protein,CRP)与前白蛋白(prealbumin,PA)及其比值对尘肺病合并肺部感染患者预后的评估价值.方法:选取2010年1月—2020年6月苏州市第五人民医院收治的尘肺病合并肺部感染患者129例作为研究对象,按死亡或生存情况分为死亡组(63例)和生存组(66例);检测患者血清CRP、PA水平并计算CRP/PA比值,比较2组患者的一般资料,入院后CRP和PA水平,不同分期尘肺病患者CRP和PA值及不同CRP/PA值患者病死率的差异.结果:尘肺病合并肺部感染死亡组患者的住院天数为(26.48±19.76)d,明显长于生存组为(18.61±12.73)d(P＜0.05);死亡组患者入院第1天的CRP值显著高于生存组(P＜0.001),PA值显著低于生存组(P＜0.05);死亡组患者入院第1天与第7天的CRP值、PA值经比较其差异无统计学意义(P＞0.05);而生存组患者入院第7天PA值显著高于第1天(P＜0.05),CRP值低于第1天,但经比较其差异无统计学意义(P＞0.05);死亡组患者入院第7天的CRP值显著高于生存组(P＜0.001),PA值显著低于生存组(P＜0.001);死亡组患者壹期、贰期和叁期的平均CRP值均显著高于生存组(P＜0.001),平均PA值均显著低于生存组(P＜0.001);死亡组患者贰期尘肺的平均PA值低于壹期和叁期患者(P＞0.05),生存组患者叁期尘肺的平均CRP值高于壹期和贰期尘肺病患者,但经比较其差异无统计学意义(P＞0.05);CRP/PA值为＞0～0.25、＞0.25～1.0和＞1.0患者的病死率经比较其差异有统计学意义(P＜0.001);死亡组患者的CRP/PA值为(1.09±1.88)显著高于生存组为(0.29+0.25)(P＜ 0.05).结论:随着CRP/PA值上升,尘肺病患者的病死率显著上升,CRP、PA及CRP/PA值可以作为尘肺病患者炎症程度及评估预后的指标;本文首次观察尘肺病患者CRP及PA水平动态变化,从而证实CRP/PA值上升将导致此类患者病死率显著上升.

[Objective] To analyze the main causes of death and the distribution of patients with pneumoconiosis who were admitted in our hospital between 2010 and 2016,provide scientific references for the prevention and treatment of pneumoconiosis.[Methods] By using the retrospective epidemiology method,the death causes of 64 pneumoconiosis cases were analyzed.[Results] In 64 death cases,there were 28 cases(43.8％) of pulmonary heart diseases,18 cases(28.1％) of malignancies,27 cases (42.2％) of cardio-cerebrovascular diseases,and 32 cases (50％) of respiratory failure.The proportion of malignant tumors in death cases of phase Ⅰ,Ⅱ,and Ⅲ pneumoconiosis was respectively 42.4％,15.4％ and 11.1％,while the fatality rate was respectively 2.51％,4.49％ and 31.03％,and the difference was statistically significant (x2=122.381,P＜0.05).The proportion of death caused by cardio-cerebrovascular diseases in patients with asbestosis was 78.6％,which was higher than that in patients with pneumosilicosis (30.6％),and the difference was statistically significant(x2=10.333,P＜0.01).The death cases in winter and spring (October to March of the next year) accounted for 73.4％ of total death cases.[Conclusion] It is important to strengthen the occupational health examination,implement the early detection and early treatment of pneumoconiosis,prevent the complications,and pay more attention to tumor screening among patients with pneumoconiosis and progression of cardio-cerebrovascular disease among patients with asbestosis.

目的 了解苏州市化学中毒救治机构解毒药物储备及抢救设备配置情况,以更好地为化学中毒救治体系建设提供依据.方法 通过问卷方式,对苏州市28家医疗机构化学中毒救治体系中10种解毒药物及12种抢救设备配置进行调查.结果 除救治中心外其余27家救治机构均未储备齐全10种解毒药物,全部28家救治机构均未配备齐全12种抢救设备.结论 苏州市化学中毒救治机构中化学中毒解毒药物和抢救设备配置不足,在救治化学中毒病例不断增长的前提下,化学中毒救治能力和救治体系建设仍需加强.