降钙素原、C反应蛋白联合早期乳酸清除率在小儿脓毒症预后评估中的价值  

Value of Procalcitonin and C-reactive Protein Combined with Early Lactate Clearance in the Prognosis of Pediatric Sepsis

作　　者：张阳星 曾君 Zhang Yangxing;Zeng Jun(Department of Pediatrics,Meizhou Fengshun County People's Hospital,Meizhou 514300,Guangdong Province,China)

机构地区：[1]梅州市丰顺县人民医院儿科,广东梅州514300

出　　处：《中外医药研究》2024年第31期147-149,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨降钙素原(PCT)、C反应蛋白(CRP)联合早期乳酸清除率在小儿脓毒症预后评估中的价值。方法:回顾性分析2018年1月—2023年1月梅州市丰顺县人民医院收治的67例脓毒症患儿的病历资料,所有患儿均接受血清PCT、CRP及动脉血乳酸检测,计算早期乳酸清除率,根据患儿预后分为存活组(42例)及死亡组(25例),比较不同预后患儿各指标水平,采用Cox回归分析患儿预后的独立影响因素,采用受试者工作特征曲线分析PCT、CRP、早期乳酸清除率单独检测及联合检测对于脓毒症患儿预后的预测价值。结果:死亡组PCT、CRP水平高于存活组,早期乳酸清除率低于存活组,差异有统计学意义(P<0.001)。Cox回归分析结果显示,血清PCT、CRP表达水平升高及早期乳酸清除率下降为脓毒症患儿死亡的独立危险因素(P<0.05)。PCT、CRP、早期乳酸清除率单独检测及联合检测预测脓毒症患儿预后的AUC分别为0.752、0.673、0.781、0.915,联合检测的效能最佳,灵敏度为92.0%,特异度为83.3%。结论:血清PCT、CRP表达水平升高及早期乳酸清除率下降为脓毒症患儿死亡的危险因素,且血清PCT、CRP联合早期乳酸清除率评估脓毒症患儿预后的临床效能较好。Objective:To evaluate the prognostic value of procalcitonin(PCT),C-reactive protein(CRP)combined with early lactate clearance in children with sepsis.Methods:The medical records of sixty-seven patients with sepsis admitted to Meizhou Fengshun County People's Hospital from January 2018 to January 2023 were retrospectively analyzed.All the patients received serum PCT,CRP and arterial blood lactic acid detection,and the early lactic acid clearance was calculated.The children were divided into survival group(42 cases)and death group(25 cases).The indexes of different prognosis were compared.The independent prognostic factors were analyzed by Cox regression.The predictive value of PCT,CRP and early lactic acid clearance alone and combined detection for the prognosis of children with sepsis was analyzed by receiver operating characteristic curve.Results:The levels of PCT and CRP in the death group were higher than those in the survival group,and the early lactic acid clearance was lower than that in the survival group,the difference was statistically significant(P<0.001).Cox regression analysis showed that the increase of serum PCT and CRP expression levels and the decrease of early lactate clearance were independent risk factors for death in children with sepsis(P<0.05).The AUC of PCT,CRP and early lactic acid clearance alone and combined detection were 0.752,0.673,0.781 and 0.915,respectively,and the combined detection was the best in predicting the prognosis of sepsis children,the sensitivity was 92.0%and the specificity was 83.3%.Conclusion:Increased expression levels of serum PCT and CRP and decreased early lactate clearance are risk factors for death in children with sepsis,and the combination of serum PCT and CRP with early lactate clearance has better clinical efficacy in evaluating the prognosis of children with sepsis.

关 键 词：降钙素原 C反应蛋白 早期乳酸清除率 小儿脓毒症 

分 类 号：R720.597[医药卫生—急诊医学]