多脏器功能不全综合征患者血浆降钙素原测定的临床意义

The clinical significance of detection of plasma procalcitonin in patients with multiple organ dysfunction syndrome

目的探讨多脏器功能不全综合征(MODS)患者血浆降钙素原(PCT)测定的临床意义。方法对36例MODS患者进行脓毒症相关脏器衰竭(SOFA)评分,连续观察30 d并记录生存率,于入院后第1 d、3 d、5 d、7 d和15 d行静脉采血,测定血浆PCT及C反应蛋白(CRP)含量。结果血浆PCT水平和MODS严重程度呈正相关(r=0.724,P<0.01),SOFA评分越高,血浆PCT水平越高[SOFA0～6分PCT为(0.82±0.23)ng/ml,SOFA 19～24分PCT为(23.61±3.20)ng/ml];CRP水平与SOFA评分无明显相关(r=0.136,P>0.05)。发病后3 d至15 d内,死亡组患者血浆PCT水平显著高于存活组(P<0.01),两组患者血浆CRP水平无明显差异。结论在评价MODS疾病进展及预后方面,血浆PCT测定优于CRP测定。

Objective To explore the clinical value of detection of plasma procalcitonin （PCT） in patients with multiple organ dysfunction syndrome （MODS）. Methods The sepsis-related organ failure assessment （SOFA） score was subjected to 36 patients with MODS, and survival rate was evaluated continuously in 30 days. Blood samples were collected at 1,3, 5,7 and 15 d after admission, and plasma PCT and CRP were determined. Results There was a significant correlation between plasma PCT and SOFA scores （r =0. 724, P 〈0.01 ）, which higher SOFA scores were associated with higher PCT： SOFA 0 -6 to PCT （0.82 ± 0.23 ） ng/ml and SOFA 19 -24 to PCT （23.61± 3.20） ng/ml. There was no correlation between plasma CRP and SOFA scores （ r = 0. 136, P 〉 0.05 ）. The plasma PCT of non-surviving patients was significantly higher than that of survivors from 3 to 15d after admission （P 〈 0.01 ）. However, CRP showed no difference between two groups. Conclusion Compared with CRP, the plasma PCT plays a more important role in evaluating the development and prognosis of MODS.