血清PCT联合SOFA评分对重度肺部感染合并脓毒症患者的预后价值分析  

Prognostic Value of Serum PCT Combined with SOFA Score in Patients with Severe Pulmonary Infection and Sepsis

作　　者：李倩 杨在亮[2] 张秀丽 LI Qian;YANG Zailiang;ZHANG Xiuli(Department of Respiratory Medicine,Chongqing Sixth People's Hospital,Chongqing 400060)

机构地区：[1]重庆市第六人民医院呼吸内科,重庆400060 [2]重庆市中医院乳腺外科,重庆400000

出　　处：《中国急救复苏与灾害医学杂志》2020年第10期1217-1220,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 探讨血清降钙素原(PCT)联合序贯器官衰竭评分(SOFA)评分对重度肺部感染合并脓毒症患者的预后价值.方法 选取2017年1月—2018年4月重庆市第六人民医院呼吸内科重症监护病房收治的73例重度肺部感染患者作为研究对象,其中脓毒症43例,非脓毒症30例.根据疾病严重程度将脓毒症患者分为一般脓毒症组(n=18)、严重脓毒症组(n=14)和脓毒性休克组(n=11).根据确诊脓毒症后28 d预后情况将脓毒症患者分为存活组(n=28)和死亡组(n=15).确诊脓毒症后6 h内采集静脉血测定血清PCT水平同时进行SOFA评分.比较不同严重程度及预后患者PCT水平和SOFA评分,对脓毒症患者PCT水平与SOFA评分进行相关性分析,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC)分析各指标对患者预后评估价值.结果 脓毒症患者PCT水平及SOFA评分明显高于非脓毒症患者(P<0.05),不同严重程度患者PCT水平及SOFA评分存在明显差异(P<0.05),死亡组患者PCT水平及SOFA评分明显高于存活组(P<0.05).脓毒症患者PCT水平与SOFA评分呈正相关(P<0.05),PCT联合SOFA评分的AUC明显大于对PCT、SOFA评分(P<0.05).结论 血清PCT与SOFA评分与重度肺部感染合并脓毒症患者疾病严重程度密切相关,同时PCT联合SOFA评分可明显提高对患者预后评估准确性.Objective To investigate the prognostic value of serum procalcitonin(PCT)combined with Sequential Organ Fients with severe pulailure Assessment(SOFA)score in patients with severe pulmonary infection and sepsis.Methods 73 patmonary infection in ICU of Chongqing sixth people's Hospital from January 2017 to April 2018 were enrolled,including 43 cases of sepsis and 30 cases of non-sepsis.Patients with sepsis were divided into groups according to the severity of the disease and prognosis,general sepsis group(n=18),severe sepsis group(n=14),septic shock group(n=11),survival group(n=28)and death group(n=15).PCT levels and SOFA scores were detected within 6h of the diagnosis,and were compared among groups.The correlation between PCT level and SOFA score of sepsis patients was analyzed.The area under ROC curve(AUC)was calculated to analyze the prognostic value of each index.Results PCT level and SOFA score of sepsis patients were significantly higher than those of non sepsis patients(P<0.05).PCT level and SOFA score showed significant difference in patients with different severity degrees(P<0.05).PCT level and SOFA score of death group were significantly higher than those of survival group(P<0.05).PCT level was positively correlated with SOFA score in sepsis patients(P<0.05).The AUC of the PCT combined SOFA score was significantly greater than that of the PCT and SOFA scores(P<0.05).Conclusion Serum PCT and SOFA scores are closely related to the severity of severe pulmonary infection in patients with sepsis,and the combined detection of PCT levels and SOFA scorescan significantly improve the evaluation accuracy of patient prognosis.

关 键 词：脓毒症 血清降钙素原 序贯器官衰竭评分 预后 评估价值 

分 类 号：R563.9[医药卫生—呼吸系统]