血降钙素原测定对重症脓毒症患者急性肾损伤的预测价值  

Predictive Value of Measuring Serum Procalcitonin in Severe Sepsis Patients with Acute Kidney Injury

作　　者：方红龙[1] 陈娟[2] 罗建[1] 祝利华[1] 胡建华[1] 张伟文[1] 

机构地区：[1]浙江省衢州市人民医院重症医学科,324000 [2]浙江省衢州市人民医院检验科,324000

出　　处：《医学研究杂志》2014年第5期70-72,共3页Journal of Medical Research

基　　金：浙江省自然科学基金资助项目(LY13H200004)

摘　　要：目的评估血降钙素原对重症脓毒症患者急性肾损伤发生的预测价值。方法收集笔者医院重症医学科的重症脓毒症患者137例,根据住院期间是否发生急性肾损伤分为急性肾损伤组(63例)和非急性肾损伤组(74例),比较两组患者血常规、肾功能、降钙素原、C反应蛋白;根据AKIN推荐的急性肾损伤分期将急性肾损伤组患者分成3组,比较组间降钙素原及C反应蛋白水平;采用受试者工作曲线(ROC)评估降钙素原对重症脓毒症患者急性肾损伤的预测价值。结果两组患者间血常规、肾功能及C反应蛋白比较无统计学差异(P>0.05),重症脓毒症合并急性肾损伤组血降钙素原水平较不合并急性肾损伤组明显升高(P<0.05);血降钙素原水平与急性肾损伤的分期呈正相关(P<0.05),而C反应蛋白则与急性肾损伤的分期无显著相关性(P>0.05);ROC曲线分析得出PCT>12.48ng/ml,对于预测重症脓毒症患者急性肾损伤发生的敏感度84.7%,特异性90.4%,曲线下面积为0.911。结论血降钙素原可作为重症脓毒症患者急性肾损伤发生的早期预警指标,在重症脓毒症合并急性肾损伤患者,血降钙素原水平与急性肾损伤的严重程度正相关。Objective To evaluate the predictive value of serum procalcitonin as a biomarker for acute kidney injury of severe sepsis patients. Methods A total of 137 cases of severe sepsis patients, who were from the Intensive Care Unit of quzhou people＇s hospital, were divided into AKI group （63 cases） and non - AKI group（74 cases） according to aquired AKI or not during the period in ICU, rou- tine blood test, renal function, PCT, CRP were comporred retrospectively between two groups. According to the stage of AKI recommen- ded by AKIN, AKI group were divided into three groups. Serum PCT and CRP were compared amomg groups. Receiver operating charac- teristic cure （ROC） method was applied to evaluate the predictive value of serum procalcitonin as a biomarker for acute kidney injury of severe sepsis patients. Results Blood test,renal function and CRP had no significant difference between the two groups. In AKI group, serum PCT were obviously higher than non - AKI group. Serum PCT was positively correlated with the stage of AKI. ROC analysis showed that the sensitivity and specificity of PCT was 0. 847 and 0. 904 respectively when PCT 〉 12.48ng/ml,AUC = 0.911. Conclusion Ser- um procalcitonin could be used as an early warning marker for severe sepsis patients with AKI. In AKI group, serum procalcitonin was positively correlated with the severity of AKI.

关 键 词：降钙素原 重症脓毒症 急性肾损伤 

分 类 号：R63[医药卫生—外科学]