摘要
目的探讨脓毒症患者血清降钙素原（PCT）与急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分及预后的关系，进而了解PCT对脓毒症早期诊断和预后的影响。方法采用前瞻性方法进行研究，将北京大学第三医院急诊重症监护病房（EICU）脓毒症90例患者按照APACHEⅡ评分分组，测定患者人院后24h内PCT、超敏C反应蛋白（hs—CRP）及乳酸的水平，比较PCT、白细胞和乳酸的差异。后再根据患者28d结局不同（分为生存组和死亡组两组），比较PCT、APACHEⅡ评分、白细胞及乳酸的差异。结果低危组患者PCT为（0．15±0．14）ng／ml，低于中危组（0．62±0．61）ng／ml和高危组（5．32±5．20）ng／ml，中危组PCT低于高危组，其差异均具有统计学意义（P〈0．01）。死亡组PCT和APACHEⅡ评分明显高于生存组，差异具有统计学意义（P〈0．01）；死亡组的白细胞和乳酸高于生存组，差异具有统计学意义（P〈0．05），但PCT和APACHEⅡ评分更为明显。结论PCT与APACHEⅡ评分具有较好的相关性；联合PCT检测和APACHEⅡ评分是预测脓毒症预后较为敏感的指标。
Objective To investigate the relationships between serum procalcitonin （PCT） level and APACHE Ⅱ score as well the prognosis of septic patients. Methods Ninety patients with sepsis were collected from emergency and critical care department of Third Hospital, Peking University, Beijing. Within 24 hours after admission, the serum PCT, hypersensitive C-reactive protein （hs-CRP）, leucocyte count （WBC） and lactic acid were examined, and APACHE Ⅱ score were calculated. According to APACHE Ⅱ score, the septic patients were divided into three groups of high, median and low scores. Based on the 28 - day outcomes of patients, the patients were divided into survival group and death group. The differences in PCT, APACHE score, WBC and lactic acid between the survival group and the death group were detected. Results The serum levels of PCT were significantly higher （ P 〈 O. 01 ） in patients with high APACHE lI score （〉20） than that in patients with median score （10-20） and low score （ 〈 10）. There was significant correlation between PCT level and APACHE Ⅱ score （ r = 0. 58, P 〈 0. 01 ）. Conclusions There is a good correlation between serum PCT level and APACHE Ⅱ score. The serum PCT and APACHE Ⅱ can be used for predicting the outcomes of septic patients.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2012年第4期371-374,共4页
Chinese Journal of Emergency Medicine
