血钙水平联合降钙素原清除率对ICU脓毒症休克患者短期预后的价值  

Predictive value of serum calcium combined with procalcitonin clearance in the short-term prognosis of patients with septic shock in ICU

作　　者：孙才智[1] 魏晶晶 朱进[1] 张铮[1] SUN Caizhi;WEI Jingjing;ZHU Jin;ZHANG Zheng(Department of Emergency,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)急诊科,南京210006

出　　处：《实用医学杂志》2021年第7期899-902,共4页The Journal of Practical Medicine

基　　金：南京市医学科技发展计划项目(编号:YKK18102);南京医科大学科技发展基金面上项目(编号:2017NJMU133)。

摘　　要：目的探讨血钙联合降钙素原清除率(procalcitonin dearance,PCTc)与脓毒症休克患者短期预后的关系。方法收集我院ICU脓毒症休克患者一般临床资料,记录APACHEⅡ评分、入住ICU时的降钙素原(PCT0 h)及血钙、治疗24 h的降钙素原(PCT24 h),计算24 h的PCTc,根据ICU住院期间预后分为存活组和死亡组,ROC曲线分析上述指标对脓毒症休克患者预后的预测效能。结果与存活组相比,死亡组患者PCT 24 h水平显著升高(P <0.05),入院时血钙及24 h的PCTc均明显下降(P <0.05)。血钙、PCTc及血钙联合PCTc与APACHEⅡ呈负相关,以血钙联合PCTc相关性最强(P <0.05)。ROC曲线显示血钙联合PCTc对脓毒症休克患者预后的预测价值最大。结论血钙、PCTc是评估脓毒症休克患者ICU住院期间的病死率的有效预测指标,两者联合应用具有更高的评估价值。Objective To investigate the predictive value of serum calcium combined with PCTc in the short-term prognosis of septic shock patients.Methods The patients of septic shock admitted to ICU were enrolled.The APACHEⅡscores within 24 hours was collected after admission,the serum calcium and PCT0 hwere collected at the time of admission.In addition,procalcitonin was collected 24 h after treatment(PCT24 h)and the 24 h PCTc was calculated.The patients were divided into survival group and death group according to the prognosis during ICU hospitalization.ROC curve was drawn to analyze the diagnostic efficacy of the above indicators for the shortterm prognosis of septic shock patients.Results Compared to the survival group,PCT24 hwas significantly higher in the death group(P<0.05),the serum calcium and PCTc were lower in the death group(P<0.05).The level of serum calcium,PCTc and serum calcium combined with PCTc were significantly negatively correlated with the APACHEⅡscore,with the strongest correlation of serum calcium combined with PCTc(P<0.05).ROC curve analysis showed that the diagnostic value of serum calcium combined with PCTc was the largest.Conclusion Serum calcium and PCTc are effective prognostic indicator of ICU mortality during hospitalization for septic shock patients,and the combination of them has the higher evaluation value.

关 键 词：脓毒症休克 低钙血症 降钙素原 降钙素原清除率 预后 

分 类 号：R459.7[医药卫生—急诊医学]