评价C反应蛋白和降钙素原预测脓毒症患者撤机时机的价值  

Valuations of C reaction protein and procalcitonin to predict the time point of weaning in patients with sepsis during the treatment of mechanical ventilation

作　　者：王玉娥 余愿[2] 

机构地区：[1]西藏林芝地区人民医院干部保健科,西藏林芝860000 [2]华中科技大学同济医学院附属协和医院综合ICU

出　　处：《临床急诊杂志》2015年第8期618-620,624,共4页Journal of Clinical Emergency

摘　　要：目的:应用受试者工作特征(ROC)曲线评价C反应蛋白(CRP)和降钙素原(PCT)预测脓毒症患者撤机时机的效能和价值。方法:对达到撤机标准的112例严重脓毒症或脓毒性休克患者验血查CRP、PCT后依程序撤机,根据撤机结局分为撤机成功组(74例)和撤机失败组(38例)。比较2组间CRP和PCT的差异,并绘制CRP、PCT与撤机结局的ROC曲线。结果:撤机前,撤机成功组CRP和PCT水平均较撤机失败组低,差异有统计学意义[CRP:(11.05±5.38)vs(23.93±7.18),P<0.01;PCT:(0.86±0.11)vs(2.35±1.62),P<0.05];CRP和PCT预测撤机成功的曲线下面积(AUC)分别为0.887和0.745,最佳Youden指数为0.71和0.48,对应的节点值分别为12.5mg/L和3.55μg/L。结论:CRP和PCT对撤机结局有一定预测价值,可作为脓毒症患者撤机时机的筛查指标。Objective：To evaluate the efficacy and significance of C reaction protein and procalcitonin to predict the time point of weaning in the patients with sepsis during the treatment of mechanical ventilation（MV）by the application of ROC curve.Method：One hundred and twelve patients with sepsis in ICU under mechanical ventilation treatment were enrolled.Serum CRP and PCT levels were measured before weaning from MV.Patients were divided into weaning successful group（74cases）and weaning unsuccessful group（38cases）according to weaning outcome,and the differences of the levels for CRP and PCT were compared between the two groups.ROC curve was drawn to evaluate the prediction significance of serum CRP and PCT for predicting weaning outcome.Result：Serum levels of CRP and PCT in successful group were significantly lower than those of unsuccessful group before weaning.[CRP：（11.05±5.38）vs（23.93±7.18）,P〈0.01;PCT：（0.86±0.11）vs（2.35±1.62）,P〈0.05];the cut off point was 12.5 mg/L（CRP）and 3.55ug/L（PCT）respectively,the corresponding area under the curve（AUC）was 0.887（CRP）and 0.745（PCT）,and Youden＇s index was 0.71（CRP）and 0.48（PCT）.Conclusion：The level of serum CRP and PCT before weaning have certain predictive values on weaning outcome,and can be used as screening indicators of weaning from MV in patients with sepsis.

关 键 词：C反应蛋白 降钙素原 脓毒症 撤机 

分 类 号：R459.7[医药卫生—急诊医学]