脓毒症患者血清CRP、sTREM-1和PCT水平变化及其临床意义研究  

Changes of CRP,sTREM-1 and PCT levels in patients with sepsis and their clinical significance

作　　者：李爱林[1] 袁鼎山[1] LI Ailin;YUAN Dingshan(Emergency Department,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院急诊内科,江苏南通226001

出　　处：《东南大学学报（医学版）》2018年第4期729-733,共5页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:观察脓毒症患者血清C反应蛋白(CRP)、可溶性髓系细胞触发受体-1(sTREM-1)和降钙素原(PCT)水平变化,并分析其临床意义。方法:选取2015年3月至2016年8月在南通大学附属医院接受治疗的脓毒症患者为研究对象,同时选取健康成年人作为对照。观察两组CRP、sTREM-1、PCT水平和APACHEⅡ评分,比较不同疾病程度、不同部位感染、不同预后的脓毒症患者血清CRP、sTREM-1、PCT水平和APACHEⅡ评分的差异。结果:脓毒症患者血清CRP、sTREM-1、PCT水平和APACHEⅡ评分均高于对照组(t=59.240、60.680、29.603、34.983,均P<0.001);中重度脓毒症组患者的CRP、sTREM-1、PCT水平和APACHEⅡ评分均高于轻度脓毒症组(t=-15.216、-8.079、-16.366、-12.072,均P<0.001);肺部感染和腹腔感染组患者的CRP、sTREM-1、PCT水平和APACHEⅡ评分均高于血流感染组患者,而肺部感染和腹腔感染组患者之间比较差异无统计学意义;死亡组患者的CRP、sTREM-1、PCT水平和APACHEⅡ评分均高于存活组(t=-11.648、-9.807、-7.778、-6.742,均P<0.001)。结论:脓毒症患者血清CRP、sTREM-1和PCT水平较高,且与疾病严重程度和预后密切相关。Objective： To observe the changes of C reactive protein（ CRP）,soluble myeloid cell triggering receptor-1（ sTREM-1） and procalcitonin（ PCT） levels in patients with sepsis,and to analyze its clinical significance.Methods： The subjects with sepsis treated in Affiliated Hospital of Nantong University from March 2015 to August2016 were selected as the subjects,and healthy adults who were examined in our hospital as controls. The levels of CRP,sTREM-1,PCT and APACHE Ⅱ score in the two groups were observed,and the difference of CRP,sTREM-1,PCT levels and APACHE Ⅱ score among patients with different disease degree,different site infection and different prognosis were compared. Results： The levels of CRP,sTREM-1,PCT and APACHE Ⅱ in patients with sepsis were higher than those in the control group（ t = 59. 240,60. 680,29. 603,34. 983,P〈0. 001）; The levels of CRP,sTREM-1,PCT and APACHE Ⅱ in patients with moderate to severe sepsis were higher than those in mild sepsis group（ t =-15. 216,-8. 079,-16. 366,-12. 072,P〈0. 001）; The levels of CRP,sTREM-1,PCT and APACHE Ⅱ in the patients with lung infection and abdominal infection were higher than those in the bloodstream infection group,but there was no difference between the patients with lung infection and the abdominal infection group; The CRP,sTREM-1,PCT levels and APACHE Ⅱ scores of the patients in the death group were higher than those in the survival group（ t =-11. 648,-9. 807,-7. 778,-6. 742,P〈0. 001）. Conclusion：The levels of CRP,sTREM-1 and PCT in patients with sepsis are higher than those without sepsis,which are closely related to the severity of the disease and prognosis.

关 键 词：脓毒症 C反应蛋白 可溶性髓系细胞触发受体-1 降钙素原 感染 

分 类 号：R392.18[医药卫生—免疫学]