探讨血清PCT浓度、SVRI、SOFA评分在脓毒症患者中的相关性及临床意义  

Correlation and clinical value of PCT,SVRI,SOFA in sepsis patients

作　　者：王剑 张文[2] WANG Jian ZHANG Wen(Department of Geriatrics, Xinjiang Urumqi City Toutun River District Center Hospital, Urumqi 830023, Xinjiang, China Chinese Medicine Hospital Affiliated to Xinjiang Medieal University VIP Ward, Urumqi 830000, Xinjiang, China)

机构地区：[1]新疆乌鲁木齐市头屯河区中心医院老年病科 [2]新疆医科大学附属中医医院VIP病房

出　　处：《中国临床药理学与治疗学》2017年第4期443-447,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨结合血清降钙素原(PCT)浓度、系统血管阻力指数(SVRI)以及序贯器官衰竭估计评分(SOFA评分)三者在ICU病房脓毒症患者的早期诊断中的可行性与临床应用价值。方法:以78位脓毒症患者为研究对象,分为高SVRI、正常SVRI和低SVRI三组,记录和检测患者的年龄、性别、感染部位、SOFA评分、PCT浓度、心指数(CI)、中心静脉压(CVP)、有创平均动脉压(MAP)、全心舒张末期容积指数(GEDVI)以及血管外肺水指数(EVLWI),并对其中的相关性进行研究。结果:三组在年龄、性别以及感染部位的差异无统计学意义。低SVRI组的SOFA评分、血清PCT浓度以及CI均明显高于正常SVRI组和高SVRI组,高SVRI组与正常SVRI组脓毒症在血清PCT浓度、SOFA评分以及CI差异无统计学意义。Spearman相关分析表明:SVRI与PCT浓度、SOFA评分呈负相关(r=-6.38、-0.527,P=0.000),而与CI无相关性(r=-0.375,P=0.000);Pearson相关分析表明:PCT浓度与SOFA评分呈正相关(r=0.69,P=0.000)。结论:结合PCT浓度、SVRI、SOFA评分三因素对于评估患者的病情并制定合理的治疗方案具有重要的临床意义,值得推广。AIM： To discuss the value of the combination of serum procalcitonin concentration （PCT）, systemic vascular resistance index （SVRI） and sequential organ failure assessment score （SO- FA score） in the early diagnosis of patients with sep- sis in the intensive care unit （ICU） ward and clini- cal application. METHODS ：78 patients with sepsis were divided into the high SVRI group, the normal SVRI group and the low SVRI group on the basis of the SVRI index. The records and tests included the age, the sex, the infection, concentration of serum PCT and SOFA score, cardiac index （CI） , central venous pressure （CVP）, mean arterial pressure （MAP）, global end diastolic volume index （GED- VI） and extravascular lung water index （EVLWI） respectively. The correlations between the records were studied. RESULTS：The records of the age, gender and infection site of each group showed no statistical significance. The SOFA score, serum PCT concentration and cardiac index of low SVRI group were significantly higher than those of the normal SVRI group and the high SVRI group, respectively. There were no statistical significant of the serum PCT concentration, SOFA score and heart index difference of the high SVRI group and the normal SVRI group of patients with sepsis. The spearman analysis showed that SVRI was negatively correlated with the concentration of PCT （ r = - 6. 38, P = 0. 000）, and SOFA score （ r = - 0. 527, P = 0.000）, respective- ly. It showed no significant correlation with CI （r = - 0. 375,P = 0. 000）. The pearson analysis showed that PCT concentration was positively correlated with SOFA score （r = 0. 69, P = 0. 000）. CONCLU- SION： PCT concentration, SVRI, SOFA score were important clinical indexes in assessing the patient -s condition and make the plan for that. This method is referential for clinical application.

关 键 词：脓毒症 降钙素原 系统血管阻力指数 SOFA评分 

分 类 号：R969[医药卫生—药理学]