摘要
目的探讨血清降钙素原(PCT)对脓毒症患者病情及预后判断的价值。方法 45例脓毒症患者根据病情严重程度分为早期脓毒症A组(n=17例)、严重脓毒症B组(n=15例)、脓毒症休克C组(n=13)。各组患者均采取相应规范化治疗措施,入院明确诊断后24 h内进行血常规检测;检测血清中PCT、CRP水平;进行血培养;采用APACHEⅡ评分系统对患者急性生理学、慢性健康状况进行评分。比较各组患者血清PCT、CRP、WBC水平,APACHEⅡ评分;比较不同血清PCT水平的脓毒症患者病情及预后指标;对比血清PCT水平与血培养检测结果。结果 B组、C组血清PCT、CRP、WBC水平、APACHEⅡ评分均明显高于A组(P<0.05),C组血清PCT、CRP、WBC水平、APACHEⅡ评分均明显高于B组(P<0.05)。患者血清PCT水平与APACHEⅡ评分呈显著正相关(r=0.67,P<0.05)。随着脓毒症患者血清PCT水平的增加,患者死亡率呈升高趋势,抗感染治疗时间和住院时间有所增加。随着血清PCT水平升高,脓毒症患者血培养阳性率呈升高趋势。结论血清PCT水平持续升高提示脓毒症患者预后不良,其对脓毒症患者病情及预后判断具有指导意义。
Objective To explore the value of serum procalcitonin（ PCT） in diagnosing the disease conditions and prognosis of patients with sepsis. Methods A total of 45 patients with sepsis were divided into group A with early sepsis（ n = 17）,group B with severe sepsis（ n = 15） and group C with septic shock（ n = 13） according to the disease severity. All groups were given corresponding specific therapeutic measures,and blood detection was conducted within 24 h after certified diagnosis after hospitalization. Levels of PCT and C-reactive protein（ CRP） were detected. Blood culture was performed. APACHEⅡ score system was used to evaluate patients＇ acute physiological and chronic healthy conditions. Levels of PCT,CRP and white blood cell count（ WBC） as well as APACHEⅡscores were compared among all groups. The disease conditions and prognostic indexes of sepsis patients with different serum PCT levels,and serum PCT and blood culture results were compared among groups. Results The levels of serum PCT,CRP and WBC as well as APACHEⅡ scores were significantly higher in groups B and C than those in group A（ P〈0. 05）,which were also significantly higher in group C than those in group B（ P〈0. 05）. Serum PCT level was in positive association with APACHEⅡ score（ r = 0. 67,P〈0. 05）. With the increase of serum PCT level,patients＇ mortality was in an increasing tendency,and their anti-infection duration and hospital stays were also increased. Meanwhile,with the increase of serum PCT level,the positive rate of blood culture was also in an increasing tendency in patients with sepsis. Conclusion Persistent increase of serum PCT level indicates poor prognosis of patients with sepsis,which is of guiding significance in the diagnosis of the disease conditions and prognosis of patients with sepsis.
出处
《实用临床医药杂志》
CAS
2016年第21期48-51,共4页
Journal of Clinical Medicine in Practice
