外周血内PCT和CRP水平对脓毒症患者临床预后的评估价值

Effects of Peripheral Blood PCT and CRP Levels on Antibiotic Dose and Efficacy in Patients with Sepsis

目的探讨外周血内PCT和CRP水平对脓毒症患者临床预后的评估价值。方法回顾性分析2017年1月至2020年1月期间入住我院ICU诊断为脓毒症的100例患者,根据预后分为存活组(68例)和死亡组(32例)。测定血清PCT和CRP水平,比较两组不同时间患者外周血内PCT和CRP水平,以及SOFA评分和APACHE II评分。绘制受试者工作特征(ROC)曲线,分析PCT或CRP单独检测以及共同检测两个指标对脓毒症休克患者预后的预测价值。结果死亡组PCT和CRP水平、APACHE II评分与SOFA评分均高于存活组,差异有统计学意义(P<0.05)。ROC曲线分析表明,PCT和CRP联合检测对脓毒症的预测价值最大,优于单一指标。结论依据外周血内PCT和CRP水平对脓毒症患者进行指导抗生素药,可以缩短抗菌药物的使用时间,缩短ICU住院时间,降低住院费用,对于患者的预后有积极作用。具有良好的临床诊断和预后价值,有利于早期判断脓毒症,提高脓毒症患者预后的敏感性和准确性,反映患者感染程度,指导抗菌药物的使用。

Objective To investigate the value of peripheral blood PCT and CRP levels in the evaluation of clinical prognosis of patients with sepsis.Methods A retrospective analysis was performed on 100 patients admitted to ICU of our hospital from January 2017 to January 2020 who were diagnosed with sepsis,and they were divided into survival group(68 cases)and death group(32 cases)according to prognosis.Serum PCT and CRP levels were determined,and the levels of PCT and CRP in peripheral blood,SOFA score and APACHE II score were compared between the two groups at different time.The receiver operating characteristic(ROC)curve was drawn to analyze the prognostic value of PCT or CRP alone or together for patients with septic shock.Results The levels of PCT and CRP,APACHE II score and SOFA score in the death group were higher than those in the survival group.ROC curve analysis showed that the combined detection of PCT and CRP had the greatest predictive value for sepsis,which was better than the single index(P<0.05).Conclusion Antibiotic guidance for sepsis patients according to the levels of PCT and CRP in peripheral blood can shorten the duration of antibiotic use,shorten the length of ICU stay and reduce the hospitalization cost,which has a positive effect on the prognosis of patients.It has good clinical diagnosis and prognostic value,which is conducive to early diagnosis of sepsis,improve the sensitivity and accuracy of prognosis of patients with sepsis,reflect the degree of infection in patients,and guide the use of antibiotics.