动态监测ICU老年重症肺炎患者血清降钙素原水平的临床意义  

Clinical significance of dynamic monitoring serum procalcitonin level of elderly patients with severe pneumonia in ICU

作　　者：茹晃耀[1] 劳志刚[1] 戴良成[1] 王素宁[1] 吴昊[1] 宋斐[1] 

机构地区：[1]广东药学院附属第一医院重症医学科,广东广州510080

出　　处：《中国当代医药》2013年第21期100-101,共2页China Modern Medicine

摘　　要：目的探讨动态监测血清降钙素原(PCT)水平对判断老年重症肺炎患者病情严重程度及预后的意义。方法对62例入ICU后发生重症肺炎的老年患者于第1、3、5、7天分别进行血清PCT检测,同时根据预后将62例老年重症肺炎患者分为死亡组和存活组进行分析比较。结果 62例患者死亡18例,存活44例。死亡组第5、7天血清PCT水平[(2.05±0.14)、(3.17±0.21)ng/ml]明显高于存活组第5、7天PCT水平[(1.07±0.12)、(0.60±0.05)ng/ml],差异有统计学意义(P<0.05),且死亡组PCT水平呈持续上升趋势,而存活组呈下降趋势;死亡组第5、7天A-PACHEⅡ评分[(30.05±4.86)、(33.00±6.05)分]明显高于存活组第5、7天APACHEⅡ评分[(20.50±5.65)、(16.59±4.58)分],差异有统计学意义(P<0.05)。结论动态监测血清PCT水平对老年重症肺炎患者病情严重程度评估及判断预后有一定的意义,PCT水平持续升高提示预后不良。Objective To discuss the significance of dynamic monitoring procalcitonin（PCT） level in judging the severity of illness and prognosis in elderly patients with severe pneumonia. Methods 62 cases of elderly patients who occurred severe pneumonia after hospitalized in ICU were adopted serum PCT detection respectively on the first,third, fifth and seventh day.And according to the prognosis,62 cases of elderly patients with severe pneumonia were divided into death group and survival group,and they were analyzed and compared. Results In 62 cases of patients,18 cases died and 44 cases survived.The level of serum PCT on the fifth and seventh day respective was （2.05 ±0.14） and （3.17± 0.21）ng/ml in death group,which was significantly higher than that of survival group [（1.07 ±0.12） and （0.60±0.05） ng/ ml],the difference was statistically significant（P＆lt;0.05）.The PCT level in death group continued to rise,while that in survival group decreased.Meanwhile,the APACHE Ⅱ scores of death group on fifth and seventh day was（30.05 ±4.86） and （33.00±6.05） respectively,which was significantly higher than that of survival group [（20.50 ±5.65） and （16.59±4.58）], the difference was statistically significant （P＆lt;0.05）. Conclusion Dynamic monitoring of serum PCT level has some significance in assessment of the severity of illness and judgment of prognosis in elderly patients with severe pneumonia, and the PCT level continue to rise prompt poor prognosis.

关 键 词：老年重症肺炎 血清降钙素原 感染 

分 类 号：R446.11[医药卫生—诊断学]