降钙素原联合APACHE Ⅲ在急性重症胆管炎患者预后评估中的意义  

Procalcitionin of serum and APACHE Ⅲ can be used to predict prognosis in patients with acute cholangitis of severe type

作　　者：喻宁芳[1] 臧宁[1] 岑美婷[1] 吴振兴[1] 李江琳[2] 朱光辉[2] 

机构地区：[1]广州市第一人民医院南沙中心医院检验科,广州511457 [2]广州市第一人民医院肝胆外科,广州510180

出　　处：《广州医药》2014年第3期48-51,共4页Guangzhou Medical Journal

摘　　要：目的探讨血清PCT与APACHE Ⅲ评分在急性重症胆管炎患者预后评估中的意义。方法通过对92例急性重症胆管炎患者入院及术后1d、3d、5d检测血清PCT和进行APACHE Ⅲ评分,根据患者预后分为生存组和死亡组,分析PCT与APACHE Ⅲ和预后之间的关系。结果 92例患者生存73例,死亡19例,死亡率20.65%。生存组和死亡组术后3d、5d PCT有差异(P<0.01);APACHE Ⅲ评分在生存组和死亡组中评分值始终有差异(P<0.01)。相关性分析提示PCT在术后3d、5d与预后有相关性(P<0.01),并且在3d时PCT值与预后有最大相关系数0.89;APACHE Ⅲ评分与预后有相关性(P<0.01)。ROC曲线及曲线下面积AUC值提示PCT在3d、5d有评估作用(P<0.01),APACHE Ⅲ有持续评估作用(P<0.01)。结论术后3d、5d PCT与APACHE Ⅲ评分均能够较为准确的评估ACST患者预后,有助于及时预测死亡风险,故监测术后3d、5d PCT在临床上具有指导意义。Objective To investigate procalcitionin （PCT） of serum and APACHE Ill score in predicting the prognosis of patients with acute cholangitis of severe type （ACST）. Methods 92 patients with ACST were detected for serum PCT and APACHE III score before operation and postoperative 1d, 3d, 5d. The patients were divided into survival group and death group. The relationship between PCT, APACHE III score and prognosis were analyzed. Results 73 cases of 92 patients were survived, 19 cases dead, and the mortality rate is 20. 65%. There were significantly differences （P 〈0. 01 ） for 3d, 5d PCT between survival group and death group. APACHE III scores were significantly different （ P 〈 0. 01 ） between the survival group and death group. Correlation analysis showed that PCT in the postoperative 3d, 5d were significantly correlated （P 〈 0. 01 ） with the prognosis in the survival group and death group, and maximum correlation coefficient of 0. 89 was appeared at postoperative 3d. APACHE III scores and the prognosis were significantly correlated （P 〈 0. 01 ） via analyzing the survival group and death group. ROC curves and the area under the curve （AUC） showed that serum PCT in 3d, 5d can be used to assess the prognosis of ACST （P 〈 0. 01 ） and APACHE III scores are always （P 〈 0. 01 ）. Conclusion PCT of serum at postoperative 3d, 5d and APACHE III score can be used to predict the prognosis of patients with ACST accurately.

关 键 词：降钙素原 APACHE Ⅲ 急性重症胆管炎 

分 类 号：R575.7[医药卫生—消化系统]