血清降钙素原诊断危重感染临床分析  

Value of procalcitonin in the diagnosis of severe infection

作　　者：黄维国 

机构地区：[1]广东省阳江市阳东区人民医院,阳江529500

出　　处：《内科急危重症杂志》2017年第3期237-239,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨降钙素原(PCT)在危重感染患者临床病情评估、预后预测中的价值。方法:选取139例脓毒症患者,根据患者入住ICU 24 h内的病情状况将患者分为脓毒症组47例、严重脓毒症组54例和脓毒症休克组38例,分别比较3组患者的血清PCT水平、急性生理与慢性健康评分(APACHEⅡ)、全身性感染相关器官衰竭评分(SOFA)等指标,并根据患者预后分为存活组和死亡组,进行亚组分析。结果:入住ICU 24 h内,不同病情分组患者的血清PCT、WBC、CRP水平、APACHEⅡ及SOFA评分比较(脓毒症组<严重脓毒症组<脓毒症休克组),差异均具有统计学意义(均P<0.05);脓毒症患者的血清PCT水平与患者WBC、CRP、APACHEⅡ评分、SOFA评分均呈显著正相关(均P<0.05);存活脓毒症患者的血清PCT、WBC、CRP水平、APACHEⅡ及SOFA评分均显著低于死亡组患者(均P<0.05);PCT判断患者预后的最佳临界值为19.84 ng/m L,此时的ROC曲线下面积AUC值为0.857,灵敏度为89.27%,特异度为86.34%。结论:血清PCT水平在危重感染患者临床病情评估、预后预测中具有较高的临床价值。Objective： To investigate the value of procalcitonin（ PCT） in predicting the clinical severity and prognosis of patient with severe infection. Methods： 139 patients with sepsis were selected as the subjects of ICU. According to the basic situations of patients admitted to the ICU within 24 h,the patients were divided into sepsis group（ n = 47）,severe sepsis group（ n = 54）,and septic shock group（ n = 38）. Serum PCT levels,acute physiology and chronic health evaluation（ APACHEⅡ）,and systemic infection associated organ failure assessment（ SOFA） were compared among the three groups.According to the prognosis,the patients were divided into survival subgroup and the death subgroup for subgroup analysis.Results： In ICU 24 h,PCT,WBC,CRP level,APACHE score,and SOFA score showed significant difference among the sepsis group,severe sepsis group and septic shock group（ all P 〈 0. 05）. The PCT level in sepsis group was significantly positively correlated with WBC,CRP,APACHE score and SOFA score（ all P 〈 0. 05）. The PCT,WBC,CRP,APACHE score and SOFA score in sepsis survival subgroup were significantly lower than those in death subgroup（ all P 〈 0. 05）. The best threshold value of PCT to judge the prognosis of patients was 19. 84 ng/m L,the AUC value of the area under the ROC curve was 0. 857,the sensitivity was 89. 27%,and specificity was 86. 34%. Conclusion： PCT in the clinical assessment and prognostic prediction of severe infection patients has high clinical value.

关 键 词：降钙素原 脓毒症 预后 

分 类 号：R631[医药卫生—外科学]