危重病全身炎症反应综合征患者血清降钙素原的动态变化及其意义  

The Dynamic Changes and the Significance of Serum Procalcitonin(PCT)in Critically-ill Patients with SIRS

作　　者：时兢[1] 宋秀琴[2] 俞娅芬[2] 穆会君[1] 陈鸣宇[2] 陆荣国[1] 王烨[1] 衡军锋[1] 

机构地区：[1]南京医科大学附属无锡市第一人民医院ICU,无锡214002 [2]苏州大学附属无锡市第四人民医院ICU,无锡214062

出　　处：《临床急诊杂志》2006年第2期58-60,共3页Journal of Clinical Emergency

摘　　要：目的探讨血清降钙素原(PCT)在全身炎症反应综合征(SIRS)和多器官功能障碍综合征(MODS)发生发展中的意义及其与 SIRS/MODS 严重程度的相关性。方法选择重症监护室(ICU)危重病患者66例,在入院第1、3、5天分别测定其外周血PCT、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)。结果血清 PCT、IL-6及 TNF-α在 SIRS 组、MODS 组及死亡组均较非 SIRS 组、非 MODS 组及非死亡组明显升高,且 SIRS 组、MODS 组及死亡组 PCT、IL-6及 TNF-α始终维持在较高水平。组内比较,第1、3、5天血清 PCT 和 IL-6有逐步升高趋势,提示 PCT 和 IL-6与 MODS 和死亡组比 TNF-α更具有密切的相关关系。结论血清 PCT 是一个新的较为敏感的反映 SIRS/MODS 严重程度的指标,并能指导临床早期诊断和早期治疗。Objective To obtain insight into the role of serum procalcitonin（PCT） in SIRS/MODS,and its relationship with the severity of SIRS/MODS and to evaluate the pathogenesis of SIRS/MODS. Methods 66 critically-ill patients admitted to ICU were studied. blood sample of （PCT,IL-6,TNFa） on day 1,3 and 5 were analysed. ResuIts The serum PCT IL-6 and TNFα levels of SIRS group, MODS group and death group were consistently higher than those in non - SIRS group, non - MODS group and non - death group（ P 〈 0. 05 ）. The serum PCT,IL-6 anti TNFα levels in SIRS group,MODS group and death group each had a continuous increasing tendency at day 1,3,5. The levels of serum PCT and IL-6 appeared to be more significantly and positively correlated with morbidity of MODS and death than TNFα. Conclusion The serum PCT might be a new and more sensitive marker, reflecting the severity of SIRS/MODS. Understanding the role of PCT in critically-ill patients with SIRS/MODS may lead to innovative therapeutic and preventive measures.

关 键 词：降钙素原 全身炎症反应综合征 多器官功能障碍综合征 危重病 

分 类 号：R459.7[医药卫生—急诊医学]