血小板计数和降钙素原在预警脓毒症致多器官功能障碍综合征中的意义  

Clinical significance of the platelet count and serum procalcitionin in prediction multiple organ dysfunction syndrome for patients with sepsis

作　　者：王合金[1] 谢江霞[1] 阳书坤[1] 

机构地区：[1]深圳市龙岗区人民医院急诊科,广东深圳518172

出　　处：《临床急诊杂志》2014年第4期214-216,共3页Journal of Clinical Emergency

摘　　要：目的：观察脓毒症患者血小板计数（PC）、降钙素原（PCT）变化,探讨两者相关性及其临床意义。方法：检测81例脓毒症非多器官功能障碍综合征（MODS）患者入选后5d内PC、PCT浓度,根据5d内是否发生MODS将脓毒症患者分为脓毒症MODS组（32例）和脓毒症非MODS组（49例）,分析组间PC、血浆PCT浓度的差异和两者相关性。结果：脓毒症MODS组PC第0~5天均明显低于脓毒症非MODS组（P〈0.05）;脓毒症MODS组血浆PCT浓度均明显高于脓毒症非MODS组（P〈0.05）。受试者工作特征（ROC）曲线分析：脓毒症患者PC、血浆PCT浓度可预测5d内MODS的发生（P〈0.05）,曲线下面积分别为0.601±0.035、0.670±0.076。相关分析显示：脓毒症MODS组患者血小板计数值与血浆PCT值之间呈负相关（P〈0.05）。结论：PC和PCT变化可预测脓毒症MODS的发生,其机制可能与促炎因子的释放增加有关,可作为脓毒症患者病情评估和预后预测的指标之一。Objective：To investigate the change and clinical significance of the platelet count（PC）and serum procalcitionin（PCT）in patients with sepsis,and their relationship.Method：PC was measured with HEMACELL Plus at 0~5 days,the serum procalcitionin at 1,3,5 days after admission the clinical trial in 81 septic patients without multiple organ dysfunction syndrome（MODS）.The septic patients were divided into the group of sepsis with MODS（32cases）and the group of sepsis without MODS（49cases）according to the results of following up in 5 days.PC and PCT were compared between the groups,their relationship were analysed.Result：The PC was lower in the group of sepsis with MODS than that in the group of sepsis without MODS at 0~5 days（all P＆lt;0.05）;The PCTin the group of sepsis with MODS than the other group increased significantly on the five day after admission（all P＆lt;0.05）;Receiver operator characteristic（ROC）curves show that PC and plasma concentration of the PCT all can predict the followed MODS of the sepsis in 5 days（all P＆lt;0.05）,areas under ROC curves of the index were 0.601±0.035and 0.670±0.076;PC is negative correlation to the plasma PCT（r=-469,P＆lt;0.05）.Conclusion： The change of PC and PCT can predict the followed MODS in patients with sepsis,and the increases of the proinflammatory cytokines probably can attributed to MODS induced PC decreases in sepsis patients.Consequently,PC is maybe a tool to evaluate sepsis patients’ conditions and predict their prognosis.

关 键 词：脓毒症 血小板计数 降钙素原 多器官功能障碍综合征 

分 类 号：R459[医药卫生—治疗学]