前降钙素原和C-反应蛋白对脓毒症早期诊断及预后评估的临床价值  

Clinical value of procalcitonin and C-reactive protein in early diagnosis of sepsis and evaluation of prognosis

作　　者：周光耀[1] 张明[2] 金玲湘[1] 诸葛璐[1] 潘陈为[1] 郑毅[1] 

机构地区：[1]温州医学院附属第二医院感染内科,浙江温州325027 [2]温州医学院附属第二医院ICU,浙江温州325027

出　　处：《中华医院感染学杂志》2014年第4期1027-1029,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药卫生计划基金项目(2011RCB007)

摘　　要：目的探讨前降钙素原(PCT)和C-反应蛋白(CRP)对脓毒症早期诊断及预后评估的临床价值。方法 2012年3月-2013年3月60例脓毒症患者(脓毒症组),选取同期60例非感染性全身炎症反应综合征患者(非脓毒症组)作为研究对象,于入院第1、7天,通过双抗夹心免疫荧光发光定量分析法、免疫比浊法,分别检测和比较两组患者及脓毒症组死亡与存活者的血清PCT、CRP水平,通过ROC曲线分析,探讨PCT、CRP及联合诊断的参考意义。结果脓毒症患者入院时PCT与CPR水平分别为(4.10±1.40)ng/ml、(93.50±8.00)mg/L,非脓毒症患者分别为(0.04±0.01)ng/ml、(12.40±6.00)mg/L,两组比较差异有统计学意义(P<0.05);脓毒症死亡者第1、7天时PCT与CRP水平分别为(4.30±1.50)ng/ml、(97.70±8.20)mg/L、(4.20±1.60)ng/ml、(92.00±7.50)mg/L,均高于存活者(3.50±1.60)ng/ml、(66.50±8.50)mg/L、(1.10±0.10)ng/ml、(15.00±7.00)mg/L,两组比较差异有统计学意义(P<0.05);与CRP相比,PCT曲线下面积(AUC)明显增大,而联合诊断AUC增大更为明显。结论在脓毒症早期诊断及预后评估方面,PCT和CRP具有重要的临床价值。OBJECTIVE To study the clinical value of procaleitonin （PCT） and C-reactive protein （CRP） in early diagnosis of sepsis and evaluation of prognosis. METHODS From Mar 2012 to Mar 2013, totally 60 cases of sepsis （ the sepsis group） and 60 cases of non-infective systemic inflammatory response syndrome （ the non-sepsis group） were enrolled in the study, then the levels of serum PCT and CRP were respectively determined on the first and seventh day of admission by means of double-antibody immunofluorescence quantitative analysis and immunoturbidimetric assay, and the ROC curve analysis was performed to discuss the value of PCT, CRP, and their combination in the diagnosis of sepsis RESULTS On the admission, the level of serum PCT was（4.10 1.40） ng/ml in the sepsis patients, （0.04i0.01）ng/ml in the non-sepsis patients the level of serum CRP was（93.50 8.00）mg/L in the sepsis patients, （12.406.00）mg/L in the non-sepsis patients, with statistical significance （P d0.05）. The level of serum PCT of the death cases in the sepsis group was（4.30 1.50）ng/ml on the first day of admission, （4. 204.1.60）ng/ml on the seventh day of admission; the level of serum CRP of the death cases in the sepsis group was （97. 704.8.20）mg/L on the first day of admission, （92. 004.7.50）mg/L on the seventh day of admission, respectively higher than（3. 504.1.60）ng/ml, （66. 504.8.50）rag/L, （1. 104.0.10）ng/ml, and（15. 004- 7.00）mg/L of the survival cases, the differences between the two groups were statistically significant（P0.05）. As compared with CRP, the area under curve （AUC） of PCT was significantly enlarged, which was increased more significantly by the combination diagnosis. CONCLUSION Both PCT and CRP have significant clinical value in the early diagnosis of sepsis and the evaluation of prognosis.

关 键 词：前降钙素原 C-反应蛋白 脓毒症 临床价值 

分 类 号：R446[医药卫生—诊断学]