血清CRP,PCT水平在脓毒血症患者中的早期诊断及预后评估价值  

Evaluation Value of Serum Levels of CRP and PCT in Early Diagnosis and Prognosis of Sepsis Patients

作　　者：曹建伟[1] 曾永红[1] 常潇丹 肖国辉[1] 陈平[1] 

机构地区：[1]自贡市第一人民医院重症医学科,四川自贡643000 [2]四川卫生康复职业学院人文社科部,四川自贡643000

出　　处：《现代生物医学进展》2016年第20期3918-3921,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨血清C反应蛋白(CRP)、降钙素原(PCT)水平在脓毒血症患者中的早期诊断及预后评估价值。方法:100例重症患者按照是否发生全身感染分为脓毒血症组67例、非脓毒血症组33例;脓毒血症组按照预后分为存活组42例、死亡组25例,同时选取健康者30例为正常对照组,进入重症监护室24小时后,抽取患者静脉血8ml,CRP采用免疫比浊法,PCT采用免疫层析法检测,分析CRP、PCT水平在脓毒血症患者早期诊断及预后价值。结果:CRP、PCT水平在组间差异具有统计学意义(P<0.05),其中脓毒血症组和非脓毒血症组水平均高于对照组,脓毒血症组水平高于非脓毒血症组,差异具有统计学意义(P<0.05);脓毒血症存活组患者CRP、PCT随着住院时间延长逐渐降低,差异具有统计学意义(P<0.05),死亡组从第3天较第1天升高,第7、9天逐渐降低,但降低幅度不大,差异无统计学意义(P>0.05);同一住院时间死亡组CRP、PCT水平均高于存活组,差异具有统计学意义(P<0.05)。CRP、PCT联合并联检测对于早期发现脓毒血症具有较高的灵敏度。结论:PCT、CRP联合并联检测对于脓毒血症有更好的早期诊断价值,其表达水平可以较好地反映患者预后。Objective： To investigate the evaluation value of serum levels of C reactive protein （CRP） and procalcitonin （PCT） in the early diagnosis and prognosis of sepsis patients. Methods： A total of 100 patients with severe systemic infection were divided into sepsis group （n=67） and non-sepsis group （n=33） by whether the systemic infection occurred, and the sepsis group was divided into survival group （n=42） and death group （n=25） by prognosis; 30 healthy people were chosen as control group. After 24 hours in the intensive care unit, 8 mL of venous blood of the patients was collected, in which, the level of CRP was detected by immunoturbidimetry and the level of PCT, by ]immunochromatographic method. Analyzed the value of serum levels of CRP and PCT in early diagnosis and prognosis of the sepsis patients. Results： The difference of CRP and PCT levels between two groups were statistically significant（P〈0.05）, in which, the CRP and PCT levels of sepsis group and non-sepsis group were higher than those of control group, and the CRP and PCT levels of sepsis group were higher than those of non-sepsis group, the differences were statistically significant （P〈0.05）. The CRP and PCT levels of the patients in sepsis survival group gradually reduced along with the prolonged hospitalization time, the differences were statistically significant （P〈0.05）; the CRP and PCT levels of death group at 3th day increased compared with the lth day, and gradually decreased at the 7th and 9th day, the differences were not statistically significant （P〉0.05）. The CRP and PCT levels of the patients in death group were higher than those in sepsis survival group. Conclusion： The combination detection of CRP and PCT have better early diagnostic value for patients with sepsis, and the expression levels of CRP and PCT may reflect the prognosis of patients with sepsis.

关 键 词：脓毒血症 CRP PCT 早期诊断 预后评估 

分 类 号：R631.2[医药卫生—外科学]