PCT清除率对肺部感染所致脓毒症患者预后的临床意义  

Clinical significance of serum PCT clearance for the prognosis of patients with sepsis caused by pulmonary infection

作　　者：王海宾 徐磊[1] WANG Hai-bin;XU Lei(Department of ICU,The Third Clinical Hospital,Tianjin Medical University,Tianjin 300170,China)

机构地区：[1]天津医科大学第三中心临床学院ICU,天津300170

出　　处：《天津医科大学学报》2018年第6期529-531,共3页Journal of Tianjin Medical University

摘　　要：目的:探讨血降钙素原(PCT)清除率对肺部感染导致的脓毒症患者预后的临床意义。方法:选取我院ICU收治的因肺部感染导致脓毒症者123例,所有患者均于入院后的0、24、48、72 h采用免疫荧光法测定外周血标本PCT,根据统计数据结果计算入院后第24、48、72 h的PCT清除率。根据患者出ICU时状态分为生存组和死亡组。通过分析PCT和PCT清除率之间的差异性,绘制ROC曲线,分析PCT清除率对预后的评估能力。结果:74例患者经治疗后好转(生存组),占60.2%,49例死亡(死亡组),占39.8%。两组之间0、24 h PCT无统计学差异(P>0.05),48、72 h生存组低于死亡组,有显著统计学差异(P<0.01)。生存组与死亡组相比,PCT清除率24、48、72 h PCT清除率均高于死亡组,有显著统计学差异(P<0.01)。72 h PCT清除率ROC曲线下面积为0.779(0.688～0.87),可以作为预后判断指标。结论:在肺部感染导致的脓毒症患者死亡率与PCT水平升高有关,且72 h PCT清除率对预后评估有明显的价值。Objective： To investigate the clinical significance of serum procalcitonin （PCT） clearance rate in the prognosis of patients with sepsis caused by pulmonary infection. Methods： One hundred and twenty-four patients of sepsis caused by pulmonary infection were divided into two groups： survival group（74 patients） and death group（49 patients）.The serum PCT levels were measured at 0, 24 h, 48 h and 72 h after admission to the ICU, then the PCT clearance of the 24 h, 48 h and 72 h were calculated. The serum PCT levels and PCT clearance were compared between two groups and the ROC curve for predicting the prognosis of PCT clearance were analyzed. Results： PCT clearance was higher in the survival group than that in death group, with significant difference ： 24h[47.825（19.9-54.04）vs 8.24（-41.05-36.21）], 48 h [72.88（53.25-77.79）vs16.8（-79.31-41.33）] and 72 h [78.765（68.37-83.98）vs 28.73（-46.05-53.22）].The area under the ROC curve of the 72 h PCT clearance was 0.779 （95% CI, 0.688-0.87, P〈0.001）. Conclusion： The mortality of patients with sepsis caused by pulmonary infection is related to the PCT level increase, and the 72 h PCT clearance has significantly value for prognosis evaluation.

关 键 词：降钙素原清除率 ICU 脓毒症 预后 

分 类 号：R631[医药卫生—外科学]