和肽素与降钙素原联合测定在脓毒血症早期诊断及预后判断的临床意义  

Clinical value of joint detection of copeptin and procalcitonin in early diagnosis and prognosis for patients with sepsis

作　　者：魏益群[1] 孙钢[1] 杨淑梅[1] 

机构地区：[1]陕西省人民医院呼吸科,陕西西安710068

出　　处：《中华医院感染学杂志》2011年第18期3801-3803,共3页Chinese Journal of Nosocomiology

基　　金：陕西省卫生厅科研项目(2010H01)

摘　　要：目的探讨和肽素与降钙素原(PCT)联合测定在脓毒血症早期诊断及预后判断的临床价值。方法收集2010年5月-2011年5月住院患者120例临床资料,将入选病例分为全身炎症反应综合征(SIRS)组、脓毒血症组、严重脓毒血症组、脓毒性休克组及非SIRS对照组,比较各组患者的血清和肽素、PCT水平、<24h的炎症指标,以及APACHEⅡ和SOFA评分的差异,并进行相关分析。结果血清和肽素水平SIRS组为(3.14±0.98)ng/ml、脓毒血症组为(8.92±1.51)ng/ml、严重脓毒血症组为(14.54±2.36)ng/ml、脓毒性休克组为(28.63±3.57)ng/ml,明显高于非SIRS对照组的(0.88±0.34)ng/ml,差异有统计学意义(P<0.05),而SIRS组、脓毒血症、严重脓毒血症和脓毒血症休克患者的血清PCT水平,亦明显高于非SIRS对照;APACHEⅡ及SOFA评分也显著高于非SIRS对照组,差异均有统计学意义(均P<0.05);不同程度脓毒血症患者间和肽素水平、PCT水平、APACHEⅡ和SOFA评分差异均有统计学意义,且随脓毒血症的严重程度升高而升高(P<0.05);脓毒血症生存组的血清和肽素水平及PCT水平显著低于死亡组;APACHEⅡ和SOFA评分均显著低于死亡组(P<0.05);血清和肽素水平及PCT水平均与APACHEⅡ评分及SOFA评分呈正相关,但和肽素与脓毒血症严重程度分级之间关系更密切。结论联合检测和肽素与降钙素原对脓毒血症早期诊断及预后判断具有指导意义。OBJECTIVE To evaluate the clinical significance of the detection of serum copeptin and procalcitonin in the diagnosis and prognosis of patients with sepsis in early stage.METHODS A total of 120 patients admitted to hospital from May 2010 to May 2011 were collected,according to the definition of ACCP/SCCM Consensus conference,patients were classified into 5 groups,including non-systemic inflammatory response syndrome（SIRS）（control）group,SIRS group,sepsis group,severe sepsis group and septic shock group.The differences of serum copeptin and PCT levels,indexes of inflammation,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） scores and sepsis related organ failure assessment（SOFA） scores were compared in controls and the septic patients with different severities and their correlation was analyzed.RESULTS The copeptin levels of patients with SIRS,sepsis,severe sepsis and sepsis shock were significantly higher than that in the non-sepsis group（3.14±0.98）,（8.92±1.51）,（14.54±2.36） and（28.63±3.57） vs（0.88±0.34）ng/ml,（P〈0.05）.The APACHEⅡ and SOFA scores of the patients with survival group were lower than those with non-survival group（P〈0.05）.Copeptin and PCT concentrations were positively correlated with APACHEⅡand SOFA.Copeptin was closer than PCT in the correlation with the severity of sepsis.CONCLUSION The joint detection of serum copeptin and procalcitonin has guiding significance in the early diagnosis and prognosis for patients with sepsis.

关 键 词：和肽素 降钙素原 脓毒血症 

分 类 号：R378[医药卫生—病原生物学]