动态监测血清炎症因子在评估脓毒血症严重程度的临床价值  

The clinical value of dynamic surveillance of serum inflammation factors in the evaluation of sepsis severity

作　　者：古旭云[1] 盛博[1] 陈炜[1] 赵磊[1] 牛素平[1] 李丽娟[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院重症医学科,北京100038

出　　处：《中国卫生检验杂志》2015年第5期676-679,共4页Chinese Journal of Health Laboratory Technology

基　　金：首都医科大学附属北京世纪坛医院青年科研基金(2012-q03)

摘　　要：目的评价外周血清炎症因子的动态变化在脓毒血症患者的病情严重程度评估中的临床应用价值。方法选择脓毒血症患者101例,依据血培养阳性与否分为血培养阳性组和血培养阴性组,依据患者病情严重程度分为脓毒血症组、严重脓毒血症组、脓毒性休克组,动态观察各组患者的血浆PCT和血清CRP水平的差异。结果在脓毒血症血培养阳性组第1 d、第3 d、第5 d的血浆PCT水平及第1 d、第3 d的血清CRP水平明显高于血培养阴性组;血浆PCT水平与脓毒血症患者病情严重程度呈正相关。血清CRP水平在脓毒性休克组各时间段水平均明显高于脓毒血症组和严重脓毒血症组,从ROC曲线下面积计算得出血浆PCT的特异性与敏感性均高于血清CRP。结论动态监测血清炎症因子对脓毒血症患者的预后有着重要的临床价值,尤其是动态监测炎症因子的变化趋势有助于对脓毒血症的病情严重程度进行判断。Objective To investigate the clinical value of serum inflammation factors dynamic changes in the evaluation of sepsis severity. Methods 101 sepsis patients were collected,while according to blood culture results were divided into two groups,blood cultures positive and blood culture-negative group,while according to the severity of sepsis,were divided into sepsis group,severe sepsis group and septic shock group. And the levels differences between plasma PCT and serum CRP were dynamically surveyed. Results The PCT levels of 1,3,5 days and CRP levels of 1,3 days in the blood cultures-positive group were significantly higher than that of blood culture-negative group; positive correlation were found between PCT levels and the severity of sepsis. The levels of serum CRP in septic shock group in each time period were significantly higher than that in the sepsis group and severe sepsis group. The receiver operating characteristic（ ROC） curve showed that the specificity and sensitivity of PCT were higher than CRP. Conclusion The PCT and CRP levels in patients with sepsis have significant correlation with the severity of disease. Dynamic surveillance of serum inflammation factors has important clinical value for the prognosis of sepsis patients,and dynamic monitoring of PCT and CRP levels can help to assess the severity of sepsis.

关 键 词：降钙素原 C反应蛋白 脓毒血症 

分 类 号：R459.7[医药卫生—急诊医学]