脓毒症患者降钙素原和C⁃反应蛋白与序贯器官衰竭估计评分的相关性及其影响因素分析  

Correlation of procalcitonin and C⁃reactive protein with SOFA score in sepsis patients and its influencing factors

作　　者：刘静一 杨世海 孙旭 康婷 陈文军 吕博 蒋盼 梁显泉 梅傲冰 LIU Jingyi;YANG Shihai;SUN Xu;KANG Ting;CHEN Wenjun;LÜ Bo;JIANG Pan;LIANG Xianquan;MEI Aobing(Department of Emergency Intensive Care Unit,the People′s Hospital of Wudang,Guiyang 550018,China;Department of Urology,the Second People′s Hospital of Guiyang,Guiyang 550081,China;不详)

机构地区：[1]贵阳市乌当区人民医院重症医学科,贵阳550018 [2]贵阳市第二人民医院泌尿外科,贵阳550081 [3]贵州医科大学附属医院小儿外科,贵阳550008 [4]贵阳市第二人民医院重症医学科,贵阳550081

出　　处：《实用医学杂志》2020年第23期3241-3245,共5页The Journal of Practical Medicine

基　　金：贵州省科技计划项目(编号:黔科合[2019]4436);贵州省卫生健康委员会科学技术基金项目(编号:黔卫发gzwjkj2019⁃1⁃080);贵阳市科技计划项目(编号:筑科合同[2018]1⁃11号,筑科合同[2019]9⁃9⁃3号);贵阳市人才创新创业资助项目(编号:筑人才办合同字[2019]第33号);贵阳市临床重点学科基金项目(编号:筑卫计发[2018]346号)。

摘　　要：目的探讨脓毒症患者的降钙素原(PCT)、C⁃反应蛋白(CRP)与序贯器官衰竭估计评分(SOFA)和快速序贯器官衰竭评分(qSOFA)的相关性及影响脓毒症患者预后的危险因素。方法回顾性分析2016年1月至2020年6月在我院及贵阳市第二人民医院重症监护病房(ICU)就诊患者的临床资料。106例脓毒症患者接受PCT和CRP检测,进行SOFA和qSOFA评分。根据预后将患者分为存活组(n=82)和死亡组(n=24)。比较两组的PCT、CRP、SOFA评分和qSOFA评分。比较不同SOFA评分组和q⁃SOFA评分组的PCT和CRP值。采用Spearman相关分析PCT、CRP与SOFA和q⁃SOFA评分的关系。采用回归分析脓毒症预后的影响因素。结果与存活组相比较,死亡组饮酒、高血压发生率更高,PCT水平、SOFA评分以及q⁃SOFA评分显著升高(P<0.05)。随着SOFA和q⁃SOFA评分升高,PCT水平显著升高(P<0.05)。PCT与SOFA和q⁃SOFA评分呈正相关(r>0,P<0.05);CRP与SOFA和q⁃SOFA评分无相关性(P>0.05)。PCT、SOFA和q⁃SOFA评分为脓毒症患者死亡的危险因素(P<0.05)。结论PCT较CRP能更好地反映脓毒症患者的病情严重程度以及预后情况,当PCT结合SOFA和qSOFA评分一起使用时,更有利于临床医生对病情的判断和评估。Objective To investigate the correlation of procalcitonin(PCT)and creactive protein(CRP)with sepsis⁃related organ failure assessment(SOFA)and quick sepsis⁃related organ failure assessment(qSOFA)score in sepsis patients as well as the risk factors that affect the prognosis of sepsis patients.Methods The clinical data of the patients admitted to the intensive care unit(ICU)of the People′s Hospital of Wudang and The Second People′s Hospital of Guiyang,from January 2016 to June 2020 were retrospectively analyzed.106 sepsis patients underwent PCT and CRP testing,and SOFA and qSOFA scores were evaluated.The patients were divided into survival group(n=82)and death group(n=24)according to the prognosis.The PCT,CRP,SOFA and qSOFA score of the two groups were compared.The PCT and CRP values of different SOFA evaluation groups and qSOFA evaluation groups were compared.Spearman correlation analysis was used to analyze the correlationship of PCT and CRP with SOFA and qSOFA.The influencing factors of sepsis were analyzed by regression.Results Compared with the survival group,the incidence of drinking and hypertension was higher in the death group.PCT,SOFA and qSOFA scores were significantly increased(P<0.05).PCT increased significantly with the increase of SOFA and Q⁃SOFA scores(P<0.05).PCT was positively correlated with SOFA and qSOFA scores(r>0,P<0.05).CRP was not associated with SOFA and qSOFA scores(P>0.05).PCT,SOFA and qSOFA scores were risk factors for death in sepsis patients(P<0.05).Conclusion Compared with CRP,PCT can better reflect the severity and prognosis of sepsis patients.When PCT is used in combination with SOFA and qSOFA score,it is more beneficial for clinicians to judge and evaluate the condition.

关 键 词：脓毒症 降钙素原 C⁃反应蛋白 SOFA评分 qSOFA评分 

分 类 号：R446.1[医药卫生—诊断学]