降钙素原在判断脓毒症的病情严重程度和预后中的临床价值  

Clinical value of procalcitonin in judging severity of sepsis and predicting prognosis

作　　者：陈璐[1] CHEN Lu(Clinical Laboratory,Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院检验科,浙江金华321000

出　　处：《中国卫生检验杂志》2019年第1期89-91,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨降钙素原在脓毒症患者病情严重程度评估和预后预测的临床价值。方法选取2013年1月-2017年12月在本院收治的脓毒症患者108例,分析其入院后PCT、CRP和APACHEⅡ评分,二元Logistic回归分析脓毒症患者预后危险因素。结果脓毒症患者的病情严重程度增加,PCT、CRP和APACHEⅡ评分逐渐增高。单因素分析和Logistic回归分析显示,PCT、CRP和APACHEⅡ评分是脓毒症患者死亡的危险因素。以ROC曲线下面积计算灵敏度及特异度,PCT以12. 92 ng/ml为截断值时,其灵敏度和特异度分别为81. 25%和77. 63%,CRP以39. 90 mg/L为截断值时,其灵敏度和特异度分别为75. 00%和65. 79%,APACHEⅡ评分以30. 64分为截断值时,其灵敏度和特异度分别为71. 88%和78. 95%,PCT预测价值优于CRP和APACHEⅡ评分。结论脓毒症患者的PCT水平与疾病严重程度呈正相关,是脓毒症患者死亡危险因素,且可以用来作为判断预后的血清学指标。Objective To investigate the clinical value of procalcitonin in assessing the severity and prognosis of patients with sepsis.Methods One hundred and eight patients with sepsis treated in our hospital were selected from January 2013to December 2017.The scores of PCT,CRP and APACHE Ⅱ after admission were analyzed.Binary Logistic regression analysis was used to analyze the prognostic risk factors in sepsis.Results The severity of sepsis patients increased,and PCT,CRP,and APACHE Ⅱ scores increased gradually.Univariate analysis and Logistic regression analysis showed that PCT,CRP,and APACHE Ⅱ scores were risk factors for death in sepsis patients.The sensitivity and specificity were calculated based on the area under the ROC curve.When the cut-off of PCT was 12.92ng/ml,sensitivity and specificity was 81.25%and 77.63%,respectively.When the cut-off of CRP was 39.90mg/L,sensitivity and specificity was respectively 75.00%and 65.79%;when the cut -off of APACHE IT score was 30.64,sensitivity and specificity was 71.88%and 78.95%,respectively.The PCT prediction value was better than CRP and APACHE Ⅱ scores.Conclusion The PCT level in patients with sepsis is positively correlated with Disease severity.It is a risk factor for death in sepsis patients and can be used as a serological marker for prognosis.

关 键 词：降钙素原 C-反应蛋白 APACHEⅡ评分 危险因素 预后 

分 类 号：R459.7[医药卫生—急诊医学]