摘要
目的分析血小板减少值(PLT)和降钙素原(PCT)对脓毒血症患者预后的评估价值。方法选取我院2018年6月~2020年6月重症监护室收治的113例脓毒血症患者,根据患者30 d内存活情况分为存活组(77例)和死亡组(36例),比较两组入院时PCT、PLT水平、入院3天PLT水平,采用受试者工作特征(ROC)曲线评价患者入院时PCT水平和PLT减少值对脓毒血症预后的评估价值。结果存活组入院时PCT水平低于死亡组,差异有统计学意义(P<0.05);存活组患者入院时及入院3天PLT水平均高于死亡组,且PLT减少值低于死亡组,差异有统计学意义(P<0.05);两组入院时PCT水平与入院时PLT、入院3天PLT水平呈负相关,且与PLT减少值呈正相关(P<0.05);ROC曲线显示,PCT、PLT减少值单独及联合评估患者预后的曲线下面积分别为0.829、0.848、0.933,两者联合诊断的曲线下面积、灵敏度、特异度、阳性和阴性预测值均高于单一指标。结论PCT与PLT联合检测对脓毒血症患者病情危重程度及预后的评估具有重要意义,可作为患者病情评估及预后的指标。
Objective To analyze the prognostic value of thrombocytopenia(PLT)and procalcitonin(PCT)in patients with sepsis.Methods 113 patients with sepsis admitted to the intensive care unit of our hospital from June 2018 to June 2020 were selected.Patients were divided into survival group(77 cases)and death group(36 cases)according to their survival within 30 d.PCT and PLT levels at admission,and PLT levels within 3 d of admission were compared between the two groups,and the receiver operating characteristic(ROC)curve was used for evaluation.The value of PCT level and PLT reduction on admission to the prognosis of sepsis.Results The PCT level of the survival group was lower at admission than the death group,the difference was statistically significant(P<0.05);The PLT levels of patients in the survival group were higher at admission and 3 d after admission than in the death group,and the reduction in PLT was lower than that of the death group,the difference was statistically significant(P<0.05);The PCT level at admission of the two groups was negatively correlated with PLT at admission and PLT at 3 dafter admission,and positively correlated with PLT reduction(P<0.05);The ROC curve showed that the area under the curve for PCT and PLT reductions individually and jointly to assess the prognosis of patients are 0.829,0.848,and 0.933,respectively.The area under the curve,sensitivity,specificity,positive and negative predictive values of the combined diagnosis of the two were all higher than those of single index.Conclusion The combined detection of PCT and PLT is of great significance for the evaluation of the criticality and prognosis of patients with sepsis,and can be used as an indicator for the evaluation of the patient's condition and prognosis.
作者
王繁静
张瑛
WANG Fan-jing;ZHANG Ying(Department of Critical Care Medicine,the First People's Hospital of Zhaotong,Zhaotong 657000,Yunnan,China;Department of Laboratory Medicine,the First People's Hospital of Zhaotong,Zhaotong 657000,Yunnan,China)
出处
《医学信息》
2021年第8期106-108,共3页
Journal of Medical Information
