炎性指标与脓毒症患者病情和预后的相关性分析  

An analysis of correlation between inflammatory indicators and severity and prognosis of patients with sepsis

作　　者：周媛媛[1] 吴同启[1] 陈华尧[1] 

机构地区：[1]南京市中医院重症医学科,江苏省210000

出　　处：《江苏医药》2017年第3期177-180,共4页Jiangsu Medical Journal

摘　　要：目的探讨炎性指标与脓毒症患者病情和预后的相关性。方法回顾性分析87例脓毒症患者的临床资料。根据血培养结果分为血行感染组27例和非血行感染组60例。根据病情分为脓毒症组24例、严重脓毒症组28例、脓毒性休克组35例。检测的炎性指标包括降钙素原(PCT)、C反应蛋白(CRP)、WBC和中性粒细胞(NE),比较其在不同疾病严重程度、感染部位、急性生理与慢性健康Ⅱ(APACHEⅡ)评分及预后的差异。绘制ROC曲线,评价PCT对脓毒症的诊断价值。结果血行感染组的PCT水平高于非血行感染组(6.1ng/ml vs.2.4ng/ml)(P<0.05)。ROC曲线分析显示,PCT对血行感染组患者病情评估有较高的价值(AUC=0.654,P<0.05)。脓毒性休克组PCT、CRP、WBC、NE和APACHEⅡ评分高于脓毒症组(P<0.01或P<0.05)。PCT和WBC与APACHEⅡ评分呈正相关(r=0.35和0.27,P<0.05)。结论与其他炎性指标比较,PCT对血行感染脓毒症患者具有较高的病情评估价值。Objective To explore the correlation between inflammatory indicators and severity and prognosis of patients with sepsis.Methods Clinical data of 87 patients with sepsis were retrospectively analyzed,of whom 27 cases were blood-infected and 60 cases were non-blood-infected.Of 87 cases,35cases were with septic shock,28 cases were severe sepsis,and 24 cases were with sepsis in general.The inflammatory indicators detected were procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell and neutrophil（NE）.The differences of the inflammatory indicators in the patients with different severity,location of infection,APACHEⅡscore and prognosis were compared.The value of PCT in the diagnosis of blood-infected sepsis was analyzed by drawing ROC curve.Results The PCT level was higher in blood-infected septic patients than that in the cases with non-blood-infected（6.1ng/ml vs.2.4ng/ml）（P〈0.05）.ROC curve analysis showed that PCT had a significant diagnostic value in evaluating the patients with blood-infected sepsis（AUC=0.654,P〈0.05）.The levels of PCT,CRP,WBC,NE and APACHEⅡ scores were higher in patients with septic shock than those in patients with sepsis（P〈0.01 or P〈0.05）.The levels of PCT and WBC were positively correlated to APACHEⅡscores（r=0.35 and 0.27,P〈0.05）.Conclusion Compared with other inflammatory indicators,PCT has a higher diagnostic value in evaluating the illness state of the patients with blood-infected sepsis.

关 键 词：脓毒症 降钙素原 

分 类 号：R631[医药卫生—外科学]