严重多发伤伴腹部损伤病人血清CRP PCT水平及损伤严重程度评分ISS对脏器损伤的预测价值  

Predictive Value of Serum CRP PCT Levels and ISS in Severe Multiple Trauma Patients with Abdominal Injury

作　　者：马武剑 李玉翠 MA Wujian;LI Yucui(The Affiliated Hospital of Jining Medical College,Shandong Jining 272000,China)

机构地区：[1]济宁医学院附属医院,山东济宁272000

出　　处：《河北医学》2021年第2期288-292,共5页Hebei Medicine

基　　金：山东省科技计划项目,(编号:20170623)。

摘　　要：目的:分析严重多发伤伴腹部损伤患者血清C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)与损伤严重程度评分(Injury Severity Score,ISS)对患者脏器损伤的诊断价值及发生脏器损伤患者死亡的预测价值。方法:回顾性分析2017年8月至2020年1月我院严重多发伤伴腹部损伤患者93例临床资料,根据其有无脏器损伤分为A组48例(无脏器损伤)、B组45例(有脏器损伤),分析患者血清CRP、PCT水平与ISS评分,采用受试者特征曲线(receiver operating characteristic curve,ROC)分析CRP、PCT与ISS评分对脏器损伤的诊断价值及对存在脏器损伤患者死亡的预测价值。结果:A、B两组PCT、CRP与ISS评分比较,差异具有统计学意义(P<0.05)。根据ROC分析结果显示:PCT、CRP与ISS评分对预测脏器损伤者死亡的AUC分别为0.743、0.808、0.800;根据最佳临界值:当PCT敏感度55.6%、特异度97.7%;CRP敏感度71.1%、特异度83.3%;ISS分敏感度60.0%、特异度89.6%。B组有脏器损伤患者存活15人、死亡30人,两类患者PCT、CRP、ISS评分比较,差异具有统计学意义(P<0.05)。根据ROC分析结果显示:PCT、CRP与ISS评分对预测脏器损伤者死亡的AUC分别为0.977、0.976、0.960,根据最佳临界值:PCT其敏感度97.0%、特异度86.7%;CRP敏感度96.7、特异度86.7%;ISS分敏感度98.2%、特异度80.0%。结论:严重多发性损伤伴腹部损伤患者若存在脏器受损情况,其PCT、CRP水平及ISS评分会显著升高,且对诊断脏器损伤具有一定价值,但PCT、CRP水平及ISS对预测患者死亡具有更高价值。Objective:To analyze the diagnostic value of serum C-reactive protein(CRP),procalcitonin(PCT)and injury severity score(ISS)in patients with severe multiple trauma and abdominal injury,and the prediction of death of patients with organ injury.Methods:The clinical data of 93 patients with severe multiple trauma with abdominal injury in our hospital from August 2017 to January 2020 were retrospectively analyzed.According to the presence or absence of organ injury,the patients were divided into group A(48 cases without organ injury)and group B(45 cases with organ injury).The serum CRP,PCT levels and ISS score were analyzed,and the receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of CRP,PCT and ISS scores in organ injury and to predict death of patients with organ injury.Results:Comparison of PCT,CRP and ISS scores between groups A and B showed statistically significant differences(P<0.05).According to the ROC analysis results,the AUC of PCT,CRP and ISS scores for predicting the death of organ injuries were 0.743,0.808,and 0.800 respectively;according to the best cut-off value:PCT has a sensitivity of 55.6%and specificity is 97.7%;CRP has a sensitivity of 71.1%and specificity of 83.3%;ISS points have a sensitivity of 60.0%and specificity of 89.6%.In group B,15 patients with organ injury survived and 30 died.The PCT,CRP and ISS scores of the two types of patients were compared,and the difference was statistically significant(P<0.05).According to the ROC analysis results,the AUC of PCT,CRP and ISS scores for predicting the death of organ injuries were 0.977,0.976,and 0.960,respectively.According to the best cut-off value:PCT has a sensitivity of 97.0%and a specificity of 86.7%;CRP has a sensitivity of 96.7 and specificity of 86.7%;ISS points have a sensitivity of 98.2%and specificity of 80.0%.Conclusion:If there is organ damage in patients with severe multiple injury and abdominal injury,their PCT,CRP levels and ISS score will be significantly increased,and have certain value in the d

关 键 词：严重多发伤 腹部损伤 脏器损伤 C反应蛋白 降钙素原 

分 类 号：R656[医药卫生—外科学] R816.5[医药卫生—临床医学]