动态监测血清降钙素原水平在ICU老年重症肺炎患者的临床意义

Clinical significance of the dynamic monitoring serum procalcitonin level in senile patients with severe pneumonia in ICU

目的：探讨动态监测血清降钙素原（ PCT）在ICU老年重症肺炎患者的临床意义。方法将本院2009年3月～2013年3月70例ICU老年重症肺炎患者根据病情预后分为死亡组22例和存活组48例，使用固相夹心法酶联免疫吸附实验（ ELISA）比较两组第1天、第3天、第5天、第7天的PCT浓度。结果①两组第1天、第3天PCT浓度差异无统计学意义（P＞0.05），死亡组第5、7天血清PCT水平明显高于存活组，PCT水平在死亡组呈上升趋势而在存活组呈下降趋势；②死亡组第5、7天急性生理学与慢性健康状况评分Ⅱ（ APACHEⅡ评分）明显高于存活组（ P＜0.01）；③血清PCT和APACHEⅡ评分呈正相关（r＝0.843，P＝0.019＜0.05）。结论动态监测降钙素原对老年重症肺炎患者预后评估，具有较高的应用价值。

Objective To explore the clinical significance of dynamic monitoring the serum procalcito-nin （ PCT） in senile patients with severe pneumonia in ICU .Methods 70 cases of senile patients with severe pneumonia who were received and cured in ICU of our hospital during March 2009 to march 2013, were divided into 22 cases of death group and 48 cases of survival group according to the disease prognosis , compared PCT concentration of the two groups at 1st day, 3rd day, 5th days, 7th days by using solid-phase sandwich method enzyme-linked immunosorbent （ ELISA） .Results ①PCT concentration of the two groups were with no statisti-cal differences at day 1 and day 3 （P＆gt;0.05）, serum PCT level of the death group was obviously higher than the survival group at 5th day and the 7th day, the PCT levels were on the rise in the death group while the PCT levels were on the decline the surviral group .②the acute physiology and chronic health evaluation Ⅱ （ A-PACHEⅡscores） of the death group were significantly higher than the survival group at the 5th and the 7th day （P＆lt;0.01）;③the serum PCT and APACHE Ⅱscores were positively correlated （r=0.843, P=0.019＆lt;0.05）.Conclusion Dynamic monitoring procalcitonin has higher application value on evaluating the prognosis of senile severe pneumonia patients .