危重症患者降钙素原和肾损害相关性的临床研究

Clinical study of relativity between serum procalcitonin level and renal impairment in critically ill patients

目的 探讨危重症患者血清降钙素原（PCT）水平和肾损害（RI）之间的相关性.方法 采用前瞻性研究,对60例危重症患者在入院24 h内测定血清PCT水平,并分为异常组（PCT≥0.5μg/L,38例）和正常组（PCT〈0.5μg/L,22例）,检测血肌酐和血尿素氮的变化,计算PCT预测RI和急性肾功能不全（ARD）的灵敏度、特异度等指标.结果 异常组血肌酐为（188.91±199.48）μmol/L,血尿素氮为（13.03±9.19）mmol/L,明显高于正常组的（67.40±15.35）μmol/L、（6.91±2.06）mmol/L（P〈0.01）.PCT预测RI的灵敏度为71.79%,特异度为52.38%,预测ARD的灵敏度为91.67%,阴性预测值为95.45%.结论 检测危重症患者血清PCT水平对判断患者RI的严重程度及ARD的发生具有重要参考价值.

Objective To discuss the relativity between serum procalcitonin（PCT） level and renal impairment （RI） in critically ill patients. Methods A perspective study was performed in 60 critically ill patients. They were divided into 2 groups on the serum PCT level within 24 h： abnormal group （PCT ≥ 0.5 μg/L,38 cases） and normal group（PCT 〈 0.5 μg/L,22 cases）. The serum creatinine （SCr） and blood urea nitrogen （BUN） were observed. Acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） of the patients were recorded. Calculated the sensitivity and specificity for prediction of RI as well as acute renal dysfunction （ARD）. Results SCr [（188.91 ± 199.48） μmol/L]and BUN [（13.03 ±9.19）mmol/L]in abnormal group were significantly higher than those in normal group [（67.40 ± 15.35） μ mol/L and （6.91 ± 2.06） mmol/L]（P〈 0.01）. The sensitivity of PCT forecast RI was 71.79%, and specificity was 52.38%. The sensitivity of PCT forecast ARD was 91.67% , and negative predictive value was 95.45%. Conclusion Serum PCT level has an important value for judgement of RI and ARD in critically ill patients.