血清D-二聚体、降钙素原水平对采用连续肾脏替代疗法治疗的脓毒症伴急性肾损伤患者预后的预测价值分析  

Analysis on predictive value of serum D-dimer and procalcitonin levels in prognosis of patients with pyemia and acute kidney injury treated with continuous renal replacement therapy

作　　者：程洁[1] 陈新[2] CHENG Jie;CHEN Xin(Department of Emergency,Peking University Shougang Hospital,Beijing 100041,China;Department of General Practice,Peking University Shougang Hospital,Beijing 100041,China)

机构地区：[1]北京大学首钢医院急诊科,北京100041 [2]北京大学首钢医院全科,北京100041

出　　处：《中国当代医药》2021年第30期64-67,共4页China Modern Medicine

摘　　要：目的探讨血清D-二聚体(D-D)、降钙素原(PCT)水平对采用连续肾脏替代疗法(CRRT)治疗的脓毒症伴急性肾损伤患者预后的预测价值。方法回顾性分析2015年1月至2020年12月北京大学首钢医院采用CRRT治疗的168例脓毒症合并急性肾损伤患者的临床资料,依据患者的预后情况分为预后良好组(n=108)和预后不良组(n=60)。统计患者的血清D-D、PCT水平,分析血清D-D、PCT水平对患者预后的预测价值。结果预后不良组的血清D-D、PCT水平高于预后良好组(P<0.05);多元logistic回归分析结果显示,血清D-D、PCT水平高是脓毒症合并急性肾损伤患者CRRT治疗预后不良的危险因素(P<0.05);受试者操作特性曲线(ROC)结果显示,治疗前血清D-D、PCT水平预测脓毒症合并急性肾损伤患者急诊CRRT治疗预后不良的AUC均>0.70,预测价值均理想,且以联合预测价值最佳。结论血清D-D、PCT水平对预测脓毒症合并急性肾损伤患者CRRT治疗的预后有一定价值。Objective To investigate the predictive value of serum D-dimer(D-D)and procalcitonin(PCT)levels in prognosis of patients with pyemia and acute kidney injury treated with continuous renal replacement therapy(CRRT).Methods The clinical data of 168 patients with pyemia and acute kidney injury who were treated with CRRT in Peking University Shougang Hospital from January 2015 to December 2020 were retrospectively analyzed.According to the prognosis of the patients,they were divided into the good prognosis group(n=108)and the poor prognosis group(n=60).Serum D-D and PCT levels of the patients were statistically analyzed for the prognostic value of serum D-D and PCT levels in patients.Results The serum levels of D-D and PCT in the poor prognosis group were higher than those in the good prognosis group(P<0.05).According to the multiple logistic regression analysis,the high serum D-D and PCT levels were the risk factors for poor prognosis in patients with pyemia complicated with acute kidney injury(P<0.05).Receiver operating characteristic curve(ROC)results showed that serum D-D and PCT levels before treatment predicted the poor prognosis of emergency CRRT patients with pyemia and acute kidney injury with the AUC of>0.70,which had ideal predictive value,and the combined predictive value was the best.Conclusion Serum D-D and PCT levels have certain value in predicting the prognosis of patients with pyemia and acute kidney injury after CRRT treatment.

关 键 词：脓毒症 急性肾损伤 连续肾脏替代疗法 D-二聚体 降钙素原 

分 类 号：R459.5[医药卫生—治疗学]