摘要
目的探究降钙素原(PCT)、C反应蛋白(CRP)水平及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分与重症加强护理病房(ICU)老年重症感染严重程度、预后的关系。方法102例ICU老年脓毒症患者,均于入院24 h完成PCT、CRP检测及APACHEⅡ评估,根据病情严重程度分为单纯脓毒症组(45例)、重度脓毒症组(34例)、脓毒性休克组(23例);根据预后结局分为存活组(81例)和死亡组(21例)。比较单纯脓毒症组、重度脓毒症组、脓毒性休克组与存活组和死亡组PCT、CRP水平及APACHEⅡ评分,分析PCT、CRP水平及APACHEⅡ评分与重症感染严重程度、预后的相关性。结果脓毒性休克组PCT(8.35±2.02)ng/ml、CRP(85.63±15.96)mg/L、APACHEⅡ评分(22.49±3.05)分和重度脓毒症组PCT(5.68±1.14)ng/ml、CRP(52.49±13.04)mg/L、APACHEⅡ评分(19.87±3.67)分均高于单纯脓毒症组的(3.61±0.92)ng/ml、(35.78±8.67)mg/L、(15.02±3.15)分,差异具有统计学意义(P<0.05);脓毒性休克组PCT、CRP及APACHEⅡ评分均高于重度脓毒症组,差异具有统计学意义(P<0.05)。死亡组PCT(10.96±1.89)ng/ml、CRP(102.00±16.73)mg/L、APACHEⅡ评分(26.46±4.08)分均明显高于存活组的(3.92±0.87)ng/ml、(39.78±8.94)mg/L、(16.21±4.04)分,差异具有统计学意义(P<0.05)。Pearson分析显示,PCT、CRP、APACHEⅡ评分与重症感染严重程度呈正相关(r=0.631、0.413、0.744,P=0.012、0.036、0.006<0.05);PCT、CRP、APACHEⅡ评分与预后呈负相关(r=-0.657、-0.467、-0.878,P=0.010、0.031、0.003<0.05)。结论PCT、CRP及APACHEⅡ评分与ICU老年重症感染严重程度、预后密切相关,随着PCT、CRP、APACHEⅡ评分升高,感染程度加重、预后不良风险升高。
Objective To investigate the correlation of procalcitonin(PCT),C-reactive protein(CRP)level and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score with severity and prognosis of severe infection in elderly patients in intensive care unit(ICU).Methods 102 elderly patients with sepsis treated in ICU,all of whom completed PCT and CRP tests and APACHEⅡassessment at 24 h of admission,were divided into simple sepsis group(45 cases),severe sepsis group(34 cases),and septic shock group(23 cases)according to the severity of their disease.They were divided into survival group(81 cases)and the death group(21 cases)according to the prognostic outcome.The PCT and CRP levels and APACHEⅡscores were compared among the simple sepsis group,severe sepsis group,and septic shock group,as well as the survival group and death group,and the correlation of PCT,CRP levels and APACHEⅡscores with the severity and prognosis of severe infection was analyzed.Results The PCT,CRP,and APACHEⅡscore were(8.35±2.02)ng/ml,(85.63±15.96)mg/L,and(22.49±3.05)points in the septic shock group,and(5.68±1.14)ng/ml,(52.49±13.04)mg/L,and(19.87±3.67)points in the severe sepsis group,which were higher than(3.61±0.92)ng/ml,(35.78±8.67)mg/L,and(15.02±3.15)points in the simple sepsis group,and the differences were statistically significant(P<0.05).The PCT,CRP and APACHEⅡscores in the septic shock group were higher than those in the severe sepsis group,and the differences were statistically significant(P<0.05).The PCT(10.96±1.89)ng/ml,CRP(102.00±16.73)mg/L,and APACHEⅡscore(26.46±4.08)points in the death group were significantly higher than(3.92±0.87)ng/ml,(39.78±8.94)mg/L,and(16.21±4.04)points in the survival group,and the differences were statistically significant(P<0.05).Pearson analysis showed that PCT,CRP,and APACHEⅡscores were positively correlated with the severity of severe infection(r=0.631,0.413,0.744;P=0.012,0.036,0.006<0.05).PCT,CRP,and APACHEⅡscores were negatively correlated with prognosis(r=-0.657,-0.467,-0
作者
张萍
李玉荣
ZHANG Ping;LI Yu-rong(Respiratory Ward,Geriatric Center of Shenyang Fourth People's Hospital,Shenyang 110000,China)
出处
《中国实用医药》
2023年第4期74-76,共3页
China Practical Medicine
