降钙素原、D-二聚体以及APACHEⅡ评分对脓毒症患者预后评估的价值  

Comparison of the value of procalcitonin,D-dimer and APACHEⅡscore in evaluating the prognosis of sepsis patients

作　　者：曲凯丽 郭东风[2] Qu Kaili;Guo Dongfeng(Postgraduate Training Base of Ningxia Medical University,Gongli Hospital of Pudong New Area,Shanghai City,Shanghai;Department of Emergency Medicine,Gongli Hospital of Pudong New Area,Shanghai City,Shanghai 200135)

机构地区：[1]宁夏医科大学上海市浦东新区公利医院研究生培养基地,上海200135 [2]上海市浦东新区公利医院急诊医学科,上海200135

出　　处：《中国社区医师》2021年第10期105-106,共2页Chinese Community Doctors

摘　　要：目的:比较脓毒症发作24 h内降钙素原(PCT)、D-二聚体及急性生理与慢性健康评分(APACHEⅡ)对患者28 d预后评估的价值。方法:选取脓毒症患者84例,根据28 d预后情况分为生存组和死亡组,分析临床资料,绘制受试者工作特征曲线(ROC曲线),比较PCT、D-二聚体、APACHEⅡ评分单一指标以及两两指标联合对脓毒症患者预后评估的价值。结果:D-二聚体和APACHEⅡ评分是影响脓毒症患者预后的独立危险因素。D-二聚体联合APACHEⅡ评分对脓毒症28 d预后的ROC曲线下面积(AUC)是0.903,敏感度和特异度分别为87.5%、86.4%,优于单一指标以及PCT分别与D-二聚体或APACHEⅡ联合对预后的评估。结论:D-二聚体联合APACHEⅡ评分用于脓毒症患者的预后评估较PCT、D-二聚体、APACHEⅡ评分单一指标以及PCT与D-二聚体或APACHEⅡ评分联合指标更有效,具有更高的临床预估价值。Objective:To compare the value of Procalcitoni(PCT),D-dimer and APACHEⅡwithin 24 hours of the onset of sepsis on 28 d prognostic evaluation for patients.Methods:84 cases of patients with sepsis were enrolled,they were divided into survival group and death group according to the prognosis of 28 d,the clinical data of the two groups were analyzed,receiver operating characteristic(ROC)curves were plotted and the prognostic values of any single index of PCT,D-dimer,APACHEⅡscore and the combination of any two indexes in sepsis were compared.Results:D-dimer and APACHEⅡscore were independent risk factors for evaluating the prognosis of sepsis.The area under the ROC curve(AUC)of D-dimer combined with APACHEⅡscore for the prognosis of sepsis after 28 d was 0.903 and the sensitivity and specificity were 87.5%and 86.4%,which was better than that of single index and PCT combined with D-dimer or APACHEⅡ.Conclusion:D-dimer combined with APACHEⅡscore is more effective in evaluating the prognosis of septic patients than any single index of PCT,D-dimer,APACHEⅡscore and the combination of PCT and D-dimer or APACHEⅡscore,it has higher clinical predictive value.

关 键 词：脓毒症 降钙素原 D-二聚体 急性生理与慢性健康评分 

分 类 号：R459.7[医药卫生—急诊医学]