血清降钙素原动态检测对脓毒血症诊断和预后的应用价值分析  

Application value of serum procalcitonin in diagnosis and prognosis with sepsis

作　　者：吴钦良 嵇金陵 张小云[1] WU Qinliang;JI Jinling;ZHANG Xiaoyun(The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,223300,China)

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300

出　　处：《临床血液学杂志（输血与检验）》2018年第6期901-903,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：南京医科大学科技发展基金面上项目(No:2016NJMU144)

摘　　要：目的:探讨血清降钙素原(PCT)的动态水平在鉴别脓毒血症及评估预后的临床价值。方法:回顾性分析2017-06—2018-06入住南京医科大学附属淮安第一医院重症监护病房患者的临床资料,选择感染性疾病患者125例,根据是否伴有脓毒血症分为观察组(脓毒血症组)72例和对照组(非脓毒血症组)53例,根据患者住院期间生存状况将脓毒血症患者分为存活组与死亡组。所有患者入院后分别在第1,3,5天采集静脉血检测PCT,对观察组和对照组患者进行差异性分析,评估PCT水平变化对脓毒血症患者预后的判断价值。结果:与对照组\[(12.3±21.7)ng/ml,(8.0±14.2)ng/ml,(6.9±14.2)ng/ml\]比较,观察组第1,3,5天PCT水平均升高\[(53.3±67.0)ng/ml,(34.5±51.1)ng/ml,(22.9±41.7)ng/ml\],差异有统计学意义(t=4.86,P<0.01;t=4.19,P<0.01;t=3.03,P<0.05)。存活组第1天PCT水平为(73.1±74.1)ng/ml,显著高于死亡组(30.0±49.1)ng/ml,差异有统计学意义(t=-2.95,P<0.05),第3天和第5天PCT水平差异均无统计学意义,且存活组PCT水平显著下降。结论:PCT的检测可显著提高脓毒血症的诊断,早期检测对预测脓毒症的预后有重要的临床价值,脓毒症患者治疗过程中PCT水平持续下降,生存率则明显提高。Objective:To investigate the clinical value of serum procalcitonin(PCT)dynamic level in diagnosis and prognosis assessment of sepsis.Method:Clinical data of patients admitted to intensive care unit(ICU) of Huai'an First People's Hospital affiliated to the Nanjing Medical University from June 2017 to June 2018were retrospectively analyzed.125 patients with infections were divided into observation group(with sepsis,n=72)and control group(without sepsis ,n=53).According to hospital mortality,the sepsis patients were divided into survival group and death group.PCT measurements were recorded on day 1,day 3 and day 5.The correction between observation and conrol group were analyzed,and PCT dynamic level between survival and death gropu were assessment.Resuit:The PCT level in observation group was increased significantly compared with the control group[(53.3±67.0)ng/ml,(34.5±51.1)ng/ml,(22.9±41.7)ng/ml] vs [(12.3±21.7)ng/ml,(8.0±14.2)ng/ml,(6.9±14.2)ng/ml],t=4.86,P<0.01;t=4.19,P<0.01;t=3.03,P<0.05]on day1,3,5.In observation,group,the concentrations of PCT on day lincreased in survivors than in nonsurvivors [(73.1±74.1)ng/ml vs (30.0±49.1)ng/ml,t=-2.95,P<0.05].However,PCT levels on day 3and day 5had no significant diffience.PCT lev- els declined in survival group.Conclusion:Detection of PCT can significantly increase the diagnosis of sepsis and have a predictive value of prognosis.The levels of PCT of sepsis patients continuous declined and survival improved significantly during treatment.

关 键 词：降钙素原 脓毒血症 诊断 预后 

分 类 号：R441[医药卫生—诊断学]