PCT对危重症合并脓毒症早期诊断及预后预测的价值  

The Value of PCT in the Early Diagnosis and Prognosis Prediction of Critically Ill Patients with Sepsis

作　　者：王淑峰[1] 姚丹林[1] 彭博[2] WANG Shu-feng;YAO Dan-lin;PENG Bo(Emergency Department,Beijing Fengtai Hospital,Beijing,100071 China;ICU,Beijing Fengtai Hospital,Beijing,100071 China)

机构地区：[1]北京丰台医院急诊科,北京100071 [2]北京丰台医院ICU,北京100071

出　　处：《系统医学》2020年第14期50-52,共3页Systems Medicine

摘　　要：目的探讨降钙素原(PCT)对危重症合并脓毒症早期诊断及预后预测的价值。方法选取160例2017年6月—2019年5月在该院重症监护病房(ICU)治疗的全身炎症反应综合征(SIRS)患者,根据脓毒症的诊断标准将其分为脓毒症组(n=77)和非脓毒症组(n=83),在入院治疗的第1、3、5天分别对患者的PCT水平进行检测,并对患者行慢性健康状况Ⅱ(APACHEⅡ)评分。对脓毒症患者的预后进行评价,存活59例(存活组)和病死18例(病死组),比较两组PCT水平和APACHEⅡ评分。结果在入院治疗的第1、3、5天,脓毒症组患者的PCT水平分别为(3.7±0.6)、(1.9±0.4)、(0.9±0.3)ng/mL,非脓毒症组分别为(0.6±0.1)、(0.5±0.1)、(0.4±0.1)ng/mL,脓毒症组患者高于非脓毒症组,差异有统计学意义(t=3.269、3.578、3.008,P<0.05),脓毒症组患者的APACHEⅡ评分分别为(17.6±3.0)分、(15.0±2.6)分、(11.2±21.5)分,非脓毒症组患者的APACHEⅡ评分分别为(10.2±1.4)分、(7.5±0.8)分、(7.0±0.6)分,脓毒症组高于非脓毒症组,差异有统计学意义(t=4.261、4.036、3.124,P<0.05);脓毒症患者中病死组患者的PCT水平(10.3±1.5)ng/mL、APACHEⅡ评分(20.6±2.5)分均高于存活组(2.3±0.4)ng/mL、(14.4±1.6)分,差异有统计学意义(t=5.329、4.897,P<0.05);通过ROC曲线分析,PCT水平用于预测脓毒症患者病死的敏感性、特异性等均高于APACHEⅡ评分。结论PCT对危重症合并脓毒症早期诊断及预后预测均具有较高的准确性,有较高的推广价值。Objective To explore the value of procalcitonin(PCT)in the early diagnosis and prognosis prediction of critically ill patients with sepsis.Methods 160 patients with systemic inflammatory response syndrome(SIRS)treated in the intensive care unit(ICU)of our hospital from June 2017 to May 2019 were selected and divided into sepsis groups according to the diagnostic criteria of sepsis(n=77)and non-septic group(n=83),the patients’PCT levels were detected on the first,third,and fifth days of admission treatment,and the patients were evaluated for chronic health statusⅡ(APACHEⅡ).The prognosis of sepsis patients was evaluated.59 patients survived(survival group)and 18 died(death group).PCT levels and APACHEⅡscores were compared between the two groups.Results On the 1st,3rd,and 5th day of admission,the PCT levels of patients in the sepsis group were(3.7±0.6),(1.9±0.4),(0.9±0.3)ng/mL,and those in the non-septic group were(0.6±0.1),(0.5±0.1),(0.4±0.1)ng/mL,the patients in sepsis group were higher than those in non-sepsis group,the difference was statistically significant(t=3.269,3.578,3.008,P<0.05),the APACHEⅡscores of patients in the sepsis group were(17.6±3.0)points,(15.0±2.6)points,(11.2±21.5)points,and the APACHEⅡscores of patients in the non-septic group were(10.2±1.4)points,(7.5±0.8)points and(7.0±0.6)points,the sepsis group was higher than the non-sepsis group,the difference was statistically significant(t=4.261,4.036,3.124,P<0.05);patients in the sepsis group died of the PCT level(10.3±1.5)ng/mL and APACHE II score(20.6±2.5)points were higher than the survival group(2.3±0.4)ng/mL and(14.4±1.6)points,the difference was statistically significant(t=5.329,4.897,P<0.05);Through ROC curve analysis,the sensitivity and specificity of PCT level for predicting death in sepsis patients are higher than APACHEⅡscore.Conclusion PCT has high accuracy and early promotion value for the early diagnosis and prognosis prediction of critically ill patients with sepsis.

关 键 词：PCT 危重症 脓毒症 早期诊断 预后预测 

分 类 号：R459[医药卫生—治疗学]