EICU重症患者血清PCT、CRP及PA的变化及临床意义  

Changes and clinical significance of serum procalcitonin,C-reactive protein and prealbumin of critically ill patients in emergency intensive care unit

作　　者：高芸[1] 吴萍[1] 李莹杰[1] 罗斌[1] 戴国兴[2] 

机构地区：[1]同济大学附属同济医院营养科,上海200065 [2]同济大学附属同济医院急诊科,上海200065

出　　处：《同济大学学报（医学版）》2016年第6期78-81,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨急重症患者血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactiveprotein,CRP)及前白蛋白(prealbumin,PA)的变化以及三者的临床意义。方法选取急诊重症监护病房(EICU)2014年8月至2015年9月收治的急重症患者78例。分别比较患者入院第2天、第8天血清PCT、CRP、TP、ALB、PA水平,并根据患者急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)的评分分为低危组和高危组,比较低危组和高危组患者的血清PCT、CRP、TP、ALB、PA改变情况。结果经过有效治疗后,患者第8天血清PCT、CRP、PA与第2天比较,均有统计学意义(P<0.05);比较低危组与高危组第2天、第8天PCT、CRP、PA水平,均有统计学意义(P<0.05)。结论动态监测血清PCT、CRP、PA变化有助于评价EICU重症患者病情严重程度及治疗效果,以及时有效调整治疗方案,降低患者病死率。Objective To investigate changes and clinical significance of serum procalcitonin （ PCT）, C-reactive protein （CRP） and prealbumin （PA） of critically ill patients in emergency intensive care unit （EICU）. Methods Seventy eight critically ill patients admitted in EICU during August 2014 to September 2015 were enrolled in the study. The serum levels of PCT, CRP, TP, ALB and PA of patients at d2 and d8 after admission were measured. According to scores of Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ ）, patients were classified as low-risk and a high-risk. Changes of serum PCT, CRP, TP, ALB and PA were compared between two groups. Results Compared to d2, the serum levels of TP, ALB and PA in d8 after admission were significantly elevated and PCT and CRP were significantly reduced（ all P 〈 0. 5 ）. Serum PCT and CRP levels in low-risk group were decreased faster than those in high-risk group （ both P 〈 0. 05 ）, which were still in high levels on d8. Conclusion Monitoring of serum PCT, CRP and PA changes is helpful in assessing the severity and treatment effect of critically ill patients in the EICU.

关 键 词：急诊重症监护室 重症患者 降钙素原 C-反应蛋白 前白蛋白 APACHEⅡ评分 

分 类 号：R459.7[医药卫生—急诊医学]