降钙素原对呼吸危重症MODS的预测价值

目的研究血清降钙素原（procalcitonin，PCT）水平对呼吸危重症发生多器官功能障碍综合征（multiple organ dysfunction syndrome，MODS）的预测价值。方法选取61例呼吸危重症患者，24h内取血，采用电化学荧光法测定PCT水平，研究分PCT低水平组（PCT〈0．5μg／L）和高水平组（PCT≥0．5μg／L），评估两组患者的急性生理与慢性健康状况（acute physiology and chronic health evaluation，APACHEⅡ）评分和Marshall评分，Spearman相关分析法分别评估PCT与APACHEⅡ、Marshall评分相关性。比较两组机械通气时间、住院时间、MODS发生例数和死亡例数的差异。结果PCT高水平组APACHEⅡ评分与Marshall评分明显高于PCT低水平组，差异有统计学意义（P〈0．01）。PCT水平与APACHEⅡ评分、Marshall评分均呈正相关（分别为r=0．824，P〈0．01；r=0．718，P〈0．01）。高水平组机械通气时间、住院时间、MODS发生例数和死亡例数均高于低水平组，差异有统计学意义。结论PCT水平对呼吸危重症患者病情严重度、MODS的早期诊断和临床预后有一定的预测价值。

Objective To research the predictive value of procalcitonin on multiple organ dysfunction syndrome in critical severe respiratory diseases. Methods 61 cases of critical and severe respiratory diseases patients were recruited. PCT levels in serum within 24 hours from recruitment were measured by electrochemical method. All cases were divided into the lower level PCT group and higher level PCT group. We eveluated the acute physiology and chronic health evaluation （ APACHEⅡ ） and Marshall scores, further, we analysed the correlation between PCT levels and APACHEII, Marshall scores by Spearman correlation method, respectively. In addtion, we measured the differences of mechanical ventilation time, hospital stay, the cases of MODS and patient death. Results Compared with the lower level PCT group, APACHEII and Marshall scores in the higher level PCT group were higher with statistically significance （ P〈0.01 ） The correlation between PCT and APACHEⅡ or Marshall scores was significantly statistically significance （respectively, r=0.824, P〈0.01 and, r=0.718, P〈0.01 ） . Compared with the lower level PCT group, mechanical ventilation time, hospital stay, the cases of MODS and patient death in the higher level PCT group were higher with statistical significance. Conclusion PCT have predictive value on the desease severity, the early diagnosis of MODS and clinical prognosis of critical and severe respiratory diseases patients.