脓毒症患者血降钙素原水平对预后有评估价值  

Relationship between serum procalcitonin and platelet parameters in patients with sepsis and its value in prognosis

作　　者：赵媛 郭东风[2] 吴坤 ZHAO Yuan;GUO Dong-feng;WU Kun(Department of Critical Care Medicine,Shanghai University of TCM,Shanghai TCM-Integrated Hospital,Shanghai 200082,China;Department of Emergency Medicine,Shanghai Pudong New Area Gongli Hospital,Shanghai 200120,China)

机构地区：[1]上海市中医药大学附属曙光医院重症医学科,上海200082 [2]上海市浦东新区公利医院急诊医学科,上海200120

出　　处：《内科急危重症杂志》2024年第1期35-38,共4页Journal of Critical Care In Internal Medicine

基　　金：上海市浦东新区公利医院青年基金资助计划(2020YQNJJ-27)。

摘　　要：目的:探讨脓毒症患者血小板参数和降钙素原(PCT)水平相关性及其对预后的评估价值。方法:收集192例感染患者的临床资料,分为脓毒症组84例和普通感染组108例,比较2组患者血小板参数[血小板计数(PLT)、血小板压积、血小板平均体积(MPV)、血小板分布宽度(PDW)和大型血小板比率(P-LCR)和PCT水平]的差异,并绘制受试者工作特征(ROC)曲线,分析PCT水平和血小板参数对脓毒症预后的预测价值。结果:与普通感染组比较,脓毒症组MPV、PDW、P-LCR和PCT明显升高,当PCT≥5.0 ng/mL时,脓毒症患者PLT低于普通感染组,MPV、PDW和P-LCR高于普通感染组;PCT<0.5 ng/mL时,脓毒症患者MPV和PDW高于普通感染组;PCT≥0.5~<5.0 ng/mL时,脓毒症组MPV、PDW和PLR高于普通感染组。脓毒症组中PLT和血小板压积与PCT呈负相关(r值分别为-0.337、-0.218),MPV、PDW和P-LCR与PCT呈正相关(r值分别为0.223、0.303、0.391);血小板参数对脓毒症患者28 d预后预测分析中,ROC曲线下面积(AUC)从高到低依次为P-LCR、PDW、MPV(0.87、0.81、0.79),PCT的AUC为0.97。结论:脓毒症患者血小板参数和PCT水平与普通感染患者之间存在明显差异,PCT水平对脓毒症患者28 d预后的预测价值较高。Objective:To investigate the correlation between platelet parameters and procalcitonin(PCT) levels in patients with sepsis and common infection and their significance in the prognosis evaluation of sepsis.Methods:A total of 192 patients were collected for retrospective analysis,and platelet parameters were compared between the two groups:platelet count,thrombocytocrit,mean platelet volume(MPV),platelet distribution width(PDW) and platelet large cell ratio(P-LCR) and PCT,and the impact of PCT levels and platelet parameters on sepsis prognosis was analyzed.Results:As compared with the common infection group,MPV,PDW,P-LCR and PCT in the sepsis group were significantly increased.When PCT was greater than 5.0 ng/mL,the number of platelets in the sepsis patients was significantly decreased.MPV,PDW and PLR were significantly higher in the sepsis group than those in the common infection group.When PCT was less than 0.5 ng/mL,MPV and PDW were significantly higher in the sepsis group than in the common infection group;when PCT was at the intermediate level,MPV,PDW and P-LCR in the sepsis group were higher than those in the common infection group.In the sepsis group,the number of PLT and platelet volume were negatively correlated with PCT,and MPV,PDW and P-LCR were positively correlated with PCT.In the analysis of platelet parameters on the predictive value of 28-day prognosis,the area under the ROC curve of P-LCR,PDW,MPV was 0.87,0.81 and 0.79 respectively,and that of PCT was 0.97.Conclusion:There are significant differences in platelet parameters and PCT between patients with sepsis and common infections,and PCT has a higher predictive value in 28-day death.

关 键 词：脓毒症 降钙素原 血小板参数 

分 类 号：R515.3[医药卫生—内科学]