降钙素原检测对脓毒症病情及预后判断的指导价值(附46例分析)

Clinical significance of the surum PCT in assessing the severity and prognosis of the patients with sepsis:Analysis of 46 cases

目的探讨血清降钙素原(PCT)检测对脓毒症病情及预后判断的指导价值。方法 46例脓毒症患者按病情轻重分早期脓毒症组、严重脓毒症组和脓毒症休克组,分别比较组间血清PCT、C反应蛋白(CRP)、WBC和急性生理与慢性健康状况评分(APACHEⅡ),并行PCT与APACHEⅡ评分相关性分析;同时按PCT水平,分为PCT<5.0、5.0～<10.0、PCT≥10.0ng/mL 3组,比较各组的病死率、抗生素使用时间、住院时间和外周血培养结果。结果脓毒症休克组与其他两组比较,PCT、CRP、WBC和APACHEⅡ评分差异均有统计学意义(P<0.05);严重脓毒症组与早期脓毒症组比较,PCT、CRP、APACHEⅡ差异有统计学意义(P<0.05),WBC差异无统计学意义(P>0.05),PCT与APACHEⅡ评分之间呈显著正相关(r=0.68,P<0.05);随着PCT水平升高,脓毒症患者病死率呈增高趋势,抗生素使用时间及住院时间延长(P<0.05),同时血培养阳性率升高。结论血PCT对脓毒症病情判断及评估预后有一定指导意义。

Objective To evaluate the significance of serum procalcitonin （PCT） for estimation of severity and prognosis in patients with sepsis. Methods A total of 46 patients with sepsis were divided into three groups according to clinical severity.. early sepsis group, sever sepsis group and septic shock group. To study the difference of serum PCT, CRP, WBC and A- PACHE Ⅱscores in all groups and explore the prognostic significance of the biological markers, and correlation was analyzed be- tween PCT and APACHE Ⅱ scores. Meanwhile, all patients were divided into three groups depending on different levels of ser- um PCT 〈5 ng/mL group, 5.0-〈10.0 ng/mL group, ≥10.0 ng/mL group. The mortality, the length of using antibiotics and hospital stay were analyzed. At the same time, the samples were performed the blood culture. Results The levels of PCT, CRP, WBC and APACHEⅡ scores in septic shock were significantly higher than the severe sepsis group and the early sepsis group, compared the difference was significant （P〈0.05）. The levels of PCT, CRP and APACHEⅡ scores were significantly different between early sepsis group and severe sepsis group （P〈0.05）, however, the level of WBC was not （P〈0.05）, and significant positive correlation between PCT and APACHEⅡ （r=0. 68, P〈0.05） was found. With increasing PCT levels, the morbidity, the length of using antibiotics and hospital stay increased （P〈0.05）, and the positive rate of the blood culture also improved. Conclusion Detecting serum PCT can be useful for assessment of severity and prognosis in patients with sepsis.