降钙素原结合APACHE Ⅱ评分在老年重症感染患者中的诊断和预后意义  

Diagnostic and prognostic implication of procalcitonin combined with APACHE Ⅱ score in elderly patients with severe infection

作　　者：郑秀芹[1] 钟晓梅[1] 马建华[1] 王一冰[1] 

机构地区：[1]承德市中心医院重症医学科,河北承德067000

出　　处：《中国感染与化疗杂志》2015年第1期47-50,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的评价血清降钙素原(PCT)结合急性生理与慢性健康(APACHEⅡ)评分在重症监护病房(ICU)老年重症感染患者中病情预测的价值。方法回顾性分析承德市中心医院ICU249例患者临床资料,根据临床表现、实验室检查,分为感染组131例,其中脓毒症48例,重度脓毒症43例,脓毒性休克40例;非感染组118例。比较两组PCT水平和APACHEⅡ评分结果。结果感染组PCT水平显著高于非感染组,差异有统计学意义(P<0.01);感染组中,PCT水平及APACHEⅡ评分均随病情加重而增高,差异有统计学意义(P<0.05)。PCT与APACHEⅡ评分显著相关(P<0.05)。结论PCT结合APACHEⅡ评分在指导ICU老年重症感染患者病情预测方面有重要临床参考价值。Objective To evaluate the early diagnostic and prognostic implication of procalcitonin （PCT） combined with APACHE Ⅱ score in elderly patients with severe infection in intensive care unit （ICU）. Methods The clinical data of 249 patients in ICU of Chengde Central Hospital were retrospectively analyzed. According to the clinical manifestations, laboratory examination, microbiology tests, 249 patients were divided into infection group （131 cases） and non-infection group （118 cases）. The patients in the infection group were stratified into 3 strata based on severity of infection, specifically： sepsis （48 cases）, severe sepsis （43 cases）, and septic shock （40 cases）. PCT and APACHE Ⅱ score were compared between groups and strata. Results The PCT level of infection group was significantly higher than that of non-infection group （P〈0.01）. In the infection group, higher PCT level and APACHE Ⅱ score were significantly associated with worse conditions of patients （P〈 0.05）. PCT level was also significantly correlated with APACHE Ⅱ score （P〈0.05）. Conclusions PCT level is important in early diagnosis of severe infection of elderly patients in ICU. PCT combined with APACHE Ⅱ score may provide important value in assessing the severity of infection for the elderly patients in ICU.

关 键 词：降钙素原 急性生理与慢性健康评分 重症感染 病情预测 

分 类 号：R459.7[医药卫生—急诊医学]