降钙素原、D-二聚体与乳酸对脓毒血症患者预后评估的临床价值研究

Clinical Value of Procalcitonin,D-Dimer and Lactic Acid in Estimating the Prognosis of Patients With Sepsis

目的:探讨血降钙素原、D-二聚体与乳酸3种生物标记物评价脓毒血症患者预后的临床价值。方法:56例脓毒血症患者按预后分为生存组和死亡组,比较发病早期血降钙素原、D-二聚体、乳酸水平及APACHEⅡ评分,并建立ROC曲线观察标记物对预后评估的临床价值。结果:3种标记物水平和APACHEⅡ评分在2组患者均有明显差异,3种标记物水平与APACHEⅡ评分存在明显相关;标记物阳性项目越多,病死率越高;3项标记物预测死亡的ROC曲线下面积在0.72～0.79之间。结论:血降钙素原、D-二聚体和乳酸水平均对患者的死亡有较好的预测意义,联合检测可提高预测的敏感性。

Objective：To investigate the value of procalcitonin,D-Dimer and lactic acid in estimating the prognosis of patients with sepsis.Methods：Fifty-six patients with sepsis were divided into survival group and death group according to their outcome.Levels of procalcitonin,D-Dimer and lactic acid were measured in the early stage of treatment,and APACHEⅡ were scored.ROC was constructed to observe the clinical value of the biomarkers on predicting prognosis.Results：There were significant differences in levels of 3 biomarkers and APACHEⅡ score between 2 groups,and all obviously correlated with APACHEⅡ score.The presence of more positive biomarkers,the higher the mortality were.Three biomarkers had area under the curve（AUC）around 0.72~0.79.Conclusions：Procalcitonin,D-Dimer and lactic acid all are good biomarkers for estimating patient＇s prognosis,and combined estimation can increase the sensitivity.