摘要
目的 探讨脓毒症患者血清降钙素原（PCT）与心肌肌钙蛋白I（cTnI）水平的相关性.方法 将湖北省中西医结合医院重症医学科2013年6月至2015年2月收治的126例脓毒症患者按病情严重程度分为脓毒症组、严重脓毒症组及脓毒性休克组,每组42例,监测3组患者72 h内乳酸（Lac）和中心静脉血氧饱和度（ScvO2）的变化,比较3组患者的病死率及入院后24 h内的急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、血清PCT及cTnI水平,探讨血清PCT与cTnI水平和APACHEⅡ评分的相关性.结果 脓毒症、严重脓毒症、脓毒性休克患者随着病情严重程度的增加,Lac（mmol/L）均逐渐增加（治疗前：5.82±2.42、7.97±3.76、10.30±2.82,治疗后6 h：3.63±1.54、5.08±1.98、7.50±1.35,治疗后12 h：2.70±1.55、4.13±1.96、6.23±1.16,治疗后24 h：2.58±1.35、3.95±2.44、5.25±1.13,治疗后48 h：2.15±1.82、3.86±2.36、4.12±1.72,治疗后72 h：1.83±1.04、3.78±1.84、3.74±0.87）,ScvO2均逐渐降低（治疗前：0.556±0.102、0.502±0.095、0.402±0.092,治疗后6 h：0.627±0.062、0.557±0.083、0.504±0.075,治疗后12 h：0.658±0.076、0.601±0.083、0.595±0.072,治疗后24 h：0.676±0.059、0.625±0.084、0.603±0.050,治疗后48 h：0.704±0.049、0.656±0.066、0.615±0.035、治疗后72 h：0.755±0.053、0.707±0.066、0.629±0.048）,Lac越高,ScvO2越低,3组间比较差异均有统计学意义（均P〈0.01）.脓毒症、严重脓毒症、脓毒性休克3组脓毒症患者的病死率〔11.9%（5/42）、21.4%（9/42）、38.1%（16/42）〕、血清PCT（μg/L：治疗前为5.21±2.92、17.20±4.81、40.71±5.22,治疗后4 d为2.51±1.52、10.72±3.83、46.45±4.25）、cTnI水平（μg/L：治疗前为5.31±0.82、9.50±0.31、15.12±3.15,治疗后4 d为1.16±0.62、5.35±0.53、9.24±1.25）、APACHEⅡ评分（分：治疗前为10.41±3.72、20.15±5.14、35.17±4.58,治疗后4 d为7.25±2.22、14.15±4.16、28.12±3.13）亦随脓毒症�
Objective To investigate the relationship between the levels of serum procalcitonin （PCT） and cardiac troponin I （cTnI） in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups： sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate （Lac） and central venous oxygen saturation （ScvO2） were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients＇ severity in the three groups, the levels of Lac （mmol/L） were gradually increased （prior treatment： 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment： 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment： 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment： 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment： 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment： 1.83±1.04, 3.78±1.84, 3.74±0.87）, while the levels of ScvO2 were gradually reduced （prior treatment： 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment： 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment： 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment： 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment： 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment： 0.755±0.053, 0.707±0.066, 0.629±0.048）. The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance （all P 〈 0.01）. The mortalities o
出处
《中国中西医结合急救杂志》
CAS
北大核心
2015年第5期527-530,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
