C反应蛋白和降钙素原检测对感染性休克患者的临床应用价值  

Clinical value of C-reactive protein and procalcitonin in septic shock

作　　者：张剑[1] 张宁[1] 刘宏[1] 陈义鹏[1] 何许伟[1] 

机构地区：[1]丽水市人民医院重症医学科,浙江323000

出　　处：《中国急救医学》2011年第5期444-446,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨C反应蛋白（CRP）和降钙素原（PCT）的动态变化对感染性休克患者的病情严重度及预后的相关性.方法 32例感染性休克患者入院第1天、第2天、第4天以及转出重症医学科（ICU）或死亡前最后1次的CRP、PCT、APACHEⅡ评分,按预后将患者分为死亡组及存活组进行动态观察,并做APACHEⅡ评分与CRP、PCT水平动态变化的相关性分析.结果 死亡组与存活组入院后第1天PCT和CRP比较差异均无统计学意义（P〉0.05）,死亡组第 2天、第4天和最后1次,CRP和PCT水平明显高于存活组（P〈0.05）.CRP和PCT与APACHEⅡ评分呈正相关（r=0.641,P〈0.01和r=0.638,P〈0.01）.结论 CRP、PCT持续高水平提示病情危重,所以联合动态观察CRP和PCT对评估感染性休克病情严重程度及预后有重要的临床意义.Objective To study the relationship between the changes of C - reactive protein （CRP） and procalcitonin （PCT） and the prognosis of patients with septic shock. Methods We measured CRP, PCT concentrations and APACHE Ⅱ scores in 32 patients with septic shock on first day, the second day,the fourth day in hospital and before leaving the ICU or the death. The patients were divided into survival group and dead group, and the relationships of CRP, PCT with APACHE Ⅱ scores was investigated. Results Two groups had no statistical difference in PCT and CRP concentrations on first day（P 〉 0. 05 ）. The serum level of CRP and PCT in dead group was much higher than those in survival group, and there was statistical difference between the two groups （P 〈 0. 05）. CRP and PCT concentrations had significant con＇elation with APACHE Ⅱ scores （ r = 0. 641, P 〈 0.01 and r = 0. 638, P 〈 0. 01）. Conclusion The continuous higher levels of CRP and PCT indicate that the disease was much serious, so the variation of CRP and PCT during the treatmeut has a significant relationship with the prognosis of patients with septic shoek.

关 键 词：C反应蛋白(CRP) 降钙素原(PCT) 感染性休克 急性生理和慢性健康评分Ⅱ(APACHE Ⅱ) 

分 类 号：R631.4[医药卫生—外科学]