SICU严重脓毒症患者血降钙素原和乳酸清除率的临床分析  

Clinical analysis of serum procalcitonin and lactate clearance in patients with severe sepsis in SICU

作　　者：叶华[1] 李莉[2] 钟贵芳[1] 张克林[1] 郭瑞莲[1] 程慧华[1] 何清[1] 

机构地区：[1]中山大学孙逸仙纪念医院SICU,广州510120 [2]中山大学孙逸仙纪念医院急诊科,广州510120

出　　处：《岭南现代临床外科》2015年第6期707-710,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省自然科学基金(06300724)

摘　　要：目的探讨血清降钙素原(PCT)及乳酸清除在SICU严重脓毒症患者中的临床价值。方法研究对象来源于我院SICU从2013年6月至2015年5月收治的78例严重脓毒症患者。临床数据包括血清降钙素原、APACHEⅡ评分、6 h动脉血乳酸清除率及患者预后等相关资料。根据临床结局及动脉血乳酸水平,所有患者分为存活组(n=54)和死亡组(n=24);高乳酸清除率组(n=51)和低乳酸清除率组(n=27)。结果各组年龄、性别、APACHEⅡ评分和基础血乳酸值差异无显著性意义。死亡组患者的血清PCT水平明显高于存活组(P<0.05),死亡组6 h乳酸清除率较存活组明显低(P<0.05)。无论死亡组和存活组,PCT水平与患者乳酸清除率均无相关关系(r2=0.189,P>0.05;r2=0.133,P>0.05)。结论严重脓毒症患者血清降钙素原水平升高及乳酸清除能力降低,二者水平变化间没有相关性。Objective To explore the PCT and lactate clearance in clinical value in patients with severe sepsis by monitoring changes serum PCT levels and arterial blood lactate. Methods The clinical data of 78 patients with severe sepsis admitted between June 2013 and May 2015 in SICU was analyzed retrospectively. APACHE Ⅱ score, the PCT and the lactate clearance after 6 hours were measured. The patients were divided into survival group（54 cases） and death group（24 cases） according to the disease outcome, and high lactate clearance group（58 cases） and low lactate clearance group（30 cases） according to lactate clearance rate（with 10% for the sector）. The correlation of PCT and lactate clearance was analyzed. Results There was no statistical difference among those groups in age,.sex,.APACHE Ⅱ score and the baseline of lactate..The serum PCT levels and the number of septic shock cases in the death group was significantly higher than the survival group（P〈0.05）. 6 h lactate clearance rate in death group was significantly lower than the survival group（P〈0.05）. The cases of patients with septic shock and mortality in high lactate clearance rate group were significantly lower than low lactate clearance rate group（P〈0.05）. There were no correlations between PCT and lactate clearance in death group and survival group（r2=0.189, P〉0.05; r2=0.133, P〉0.05）. Conclusion Both PCT and lactate clearance were important indications. However, there is no correlation between level of PCT with lactate clearance.

关 键 词：严重脓毒症 血清降钙素原 早期乳酸清除率 

分 类 号：R631[医药卫生—外科学]