qSOFA评分联合IL-6 PCT CRP对ICU感染性休克患者病情及预后的评估价值  

The evaluation value of qSOFA score combined with serum IL-6,PCT and CRP levels for judgment and prognosis of ICU patients with septic shock

作　　者：武道荣[1] 闫雪波[2] 方磊[2] 李睿[1] 王鹏[1] 冯开俊 宋秋鸣[1] WU Daorong;YAN Xuebo;FANG Lei(Intensive Care Unit,Third People’s Hospital of Heifei(Third Clinical College of Anhui Medical University),Hefei 230022,China)

机构地区：[1]安徽医科大学合肥第三临床学院(合肥市第三人民医院)重症医学科,合肥230022 [2]安徽医科大学第一附属医院干部呼吸与危重症医学科,合肥230021

出　　处：《安徽医学》2021年第8期850-854,共5页Anhui Medical Journal

基　　金：安徽省自然科学基金项目(项目编号:1908085QH311);合肥市第三人民医院科研课题(项目编号:SYKY201903)。

摘　　要：目的探究快速器官功能障碍评分(qSOFA)联合血清白细胞介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)水平对ICU感染性休克患者病情及预后评估的价值。方法回顾性分析2018年5月至2021年3月合肥市第三人民医院收治的93例ICU感染性休克患者的临床资料,根据患者是否合并多器官功能障碍综合征(MODS)分为轻症组及重症组,并根据28 d生存情况分为生存组及死亡组,分别比较两组患者qSOFA评分,以及血清IL-6、PCT、CRP水平差异;采用受试者工作特征(ROC)曲线分析qSOFA评分联合血清IL-6、PCT、CRP水平对ICU感染性休克患者病情严重程度及预后的评估价值。结果①重症组患者qSOFA评分及血清IL-6、PCT、CRP水平均高于轻症组,差异有统计学意义(P<0.05);qSOFA评分联合血清IL-6、PCT、CRP评估感染性休克患者病情严重程度的曲线下面积(AUC)为0.826,大于单独qSOFA评分、血清IL-6、PCT、CRP,差异有统计学意义(P<0.05);②死亡组qSOFA评分及血清IL-6、PCT、CRP水平均高于生存组,差异有统计学意义(P<0.05);qSOFA评分联合血清IL-6、PCT、CRP评估感染性休克患者死亡的AUC为0.882,大于单独qSOFA评分、血清IL-6、PCT、CRP,差异有统计学意义(P<0.05)。结论qSOFA评分联合IL-6、PCT、CRP对ICU感染性休克患者病情严重程度及预后评估具有一定的参考价值。Objective To explore the evaluation value of quick sequential organ failure assessment(qSOFA)score combined with serum interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CRP)levels for prognosis of ICU patients with septic shock.Methods Ninety-three ICU patients with septic shock in Hefei Third People’s Hospital from May 2018 to March 2021 were enrolled as the research objects.According to presence or absence of multiple organ dysfunction syndrome(MODS),they were divided into mild group and severe group,and were divided into survival group and death group according to 28 day survival.The qSOFA score,levels of serum IL-6,PCT and CRP were compared between these two groups.Receiver operating characteristic(ROC)curve was used to analyze the value of qSOFA score combined with serum IL-6,PCT and CRP levels in evaluating the severity and prognosis of ICU patients with septic shock.Results①The qSOFA score,levels of serum IL-6,PCT and CRP in severe group were higher than those in mild group(P<0.05),and AUC of qSOFA score combined with serum IL-6,PCT and CRP(0.826)in evaluating the severity of septic shock was greater than that of single qSOFA score(0.652),serum IL-6(0.765),PCT(0.703)and CRP(0.665)(P<0.05);②The qSOFA score,levels of serum IL-6,PCT and CRP in death group were higher than those in survival group(P<0.05),and AUC of qSOFA score combined with serum IL-6,PCT and CRP(0.882)in evaluating the prognosis of septic shock was higher than that of qSOFA score alone(0.733),serum IL-6(0.612),PCT(0.690)and CRP(0.747)(P<0.05).Conclusions The qSOFA score combined with serum IL-6,PCT and CRP levels has a certain reference value for the severity and prognosis assessment of ICU patients with septic shock.

关 键 词：感染性休克 快速器官功能障碍评分 白细胞介素-6 降钙素原 C反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学]