感染性休克患者降钙素原和C-反应蛋白动态变化研究  

Changes of serum levels of procalcitonin and C-reactive protein in septic shock patients

作　　者：蒋玲玉[1] 熊滨[1] 韩林[1] 庞静[1] 莫丽[1] 

机构地区：[1]广西壮族自治区人民医院重症医学科,南宁530021

出　　处：《中国临床新医学》2017年第4期333-336,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的观察降钙素原(PCT)、C-反应蛋白(CRP)等指标在感染性休克患者中的动态变化和急性生理和慢性健康(APACHEⅡ)评分在预后评估中的作用。方法回顾性分析45例感染性休克患者入院第1、3、5天以及出院或死亡前最后一次的血清PCT、CRP及入院时APACHEⅡ评分,根据预后将患者分为死亡组及存活组,并对其进行分析。结果 45例感染性休克患者生存20例,死亡25例,病死率为55.6%。死亡组患者入院时APACHEⅡ评分明显高于存活组[(28.84±8.03)分vs(21.82±7.10)分]。两组在入组第1、3天的PCT和CRP水平比较差异均无统计学意义。死亡组PCT和CRP水平在第5天及观察终点均明显高于存活组。各组内PCT和CRP与观察第1天相比,存活组随观察时间延长而明显下降,差异有统计学意义,而死亡组则无明显变化。结论患者血清中PCT、CRP呈持续高水平提示预后不佳,指标的高低对临床指导治疗和评估预后有参考意义。Objective To observe the values of procalcitonin（PCT） and C-reactive protein（CRP） and APACHE Ⅱ scores in evaluating the prognosis of the septic shock patients.Methods The peripheral serum levels of PCT and CRP,and APACHE Ⅱ scores were retrospectively analyzed in 45 patients with septic shock at the first,the third and the fifth day after admission to the hospital and the last day of staying at the hospital.The patients were divided into the survival group（n = 20） and the death group（n = 25） according to the outcomes of their prognoses.APACHE Ⅱ scores and the levels of PCT and CPR were compared between the two groups.Results Twenty-five cases survived and 20 cases died.APACHE Ⅱ sores were significantly higher in the death group than those in the survival group[（28.84 ± 8.03） vs（21.82 ± 7.10） ].There were no significant differences in PCT and CRP at the first and the third day after admission to the hospital between the two groups,however,PCT and CRP of the death group were significantly higher than those in the survival group.With the extension of the observation time,PCT and CRP were obviously decreased in the survival group.Nevertheless,the changes of them were not significant in the death group.Conclusion Persistently high levels of serum CRP and PCT indicate the poor prognoses in septic shock patients.

关 键 词：感染性休克 C-反应蛋白 APACHE Ⅱ评分 降钙素原 

分 类 号：R56[医药卫生—呼吸系统]