血清降钙素原对烧伤脓毒症患者预后的临床意义  

The prognostic clinical significance of serum procalcitonin in patients with burn sepsis

作　　者：吴琛[1] 邹同荣[1] 陈国双[1] 

机构地区：[1]宜宾市第一人民医院整形烧伤科,四川宜宾644000

出　　处：《川北医学院学报》2017年第1期96-98,105,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨血清降钙素原(procalcitonin,PCT)对烧伤脓毒症患者预后的临床意义。方法:将46例烧伤脓毒症患者根据预后情况分为存活组27例与死亡组19例。46例烧伤脓毒症患者在确诊为脓毒症时及确诊后的第1、3、5、7、9天检测血清PCT和Hs-CRP及进行急性生理学及慢性健康状况评分(APACHEⅡ评分)。在烧伤脓毒症确诊时绘制46例患者血清PCT值的受试者工作特征(ROC)曲线,分析其对死亡的预测效果。结果:死亡组血清PCT在确诊脓毒症时及确诊后的第1、3、5、7、9天一直维持较高的水平,存活组血清PCT下降,且死亡组均高于存活组(P<0.05);死亡组Hs-CRP和APACHEⅡ评分在确诊脓毒症时及确诊后的第1天与生存组比较差异无显著性(P>0.05);死亡组Hs-CRP和APACHEⅡ评分在确诊脓毒症后的第3、5、7、9天高于生存组(P<0.05)。46例烧伤脓毒症患者的血清PCT水平对死亡预测的ROC曲线下总面积为0.931,11.23 ng/m L为血清PCT的最佳阈值,灵敏度为90.6%,特异性度为100%。结论:血清PCT值可作为烧伤脓毒症患者预后判断指标,为后期临床治疗提供依据,降低病死率。Objective： To explore the prognostic clinical significance of serum procalcitonin（ PCT） in patients with burn sepsis.Methods： According to the outcome 46 cases of patients with burn sepsis were divided into two groups： survival group（ n = 27） and death group（ n = 19）. 46 cases of patients with burn sepsis were detected serum PCT and Hs-CRP and conducted acute physiology and chronic health evaluation（ APACHEⅡ score） when sepsis was diagnosed and confirmed after 1,3,5,7 and 9d. Receiver operating characteristic（ ROC） curve of serum PCT value was used to predict death for 46 burn patients when sepsis was diagnosed. Results：Death group serum PCT in the diagnosis of sepsis and confirmed after 1,3,5,7,9 d has maintained high level,survival group serum PCT decreased. Serum PCT of death group were higher than survival group（ P〈0. 05）. There were no statistically significant differences in Hs-CRP and APACHE Ⅱ score between death group and survival group when when sepsis was diagnosed and post sepsis day（ P〉0. 05）,When sepsis was diagnosed and confirmed after 3,5,7 and 9d the Hs-CRP and APACHE Ⅱ score of death group were higher than survival group（ P〈0. 05）. The total area under ROC curve of serum PCT value for predicting death for 46 patients with burn sepsis was 0. 931 and 11. 23 ng / m L was chosen as the optimal threshold value with with sensitivity of 90. 6% and specificity of 100%.Conclusion： Serum PCT value can be served as a vital prognostic indicator for patients with burn sepsis and provide the basis for clinical treatment,in order to reduce mortality.

关 键 词：降钙素原 烧伤脓毒症 预后 

分 类 号：R644[医药卫生—外科学]