降钙素原对重症肺部感染患者预后的评估价值

Value of procalcitonin in clinical evaluation of prognosis of severe pulmonary infection

目的探讨降钙素原(PCT)对重症肺部感染患者的预后评估价值,及时了解肺部感染患者的感染程度,以指导患者抗菌药物的使用。方法研究对象为2010年6月-2013年6月入住ICU的重症肺部感染患者120例,根据患者的预后分为生存组90例与死亡组30例,分别记录肺部感染患者第1、5天、转出或死亡前最后一次PCT水平和APACHEⅡ评分;数据采用SPSS 18.0统计软件进行分析,通过统计分析对两组肺部感染患者的预后进行对比,探讨PCT浓度对重症肺部感染患者的预后评估价值。结果生存组与死亡组重症肺部感染患者的年龄及入院时的PCT水平和APACHEⅡ评分差异无统计学意义,两组重症肺部感染患者入住ICU的时间、入院第5天及之后PCT水平和APACHEⅡ评分差异有统计学意义(P<0.05);PCT水平的高低与疾病的严重程度呈正相关关系;PCT水平越高、则感染越重;PCT水平持续升高者常提示患者的预后较差(r=0.979,P<0.01)。结论 PCT水平能及时反映重症肺部感染患者的严重程度,并对患者的预后评估有一定的临床指导价值。

OBJECTIVE To explore the value of procalcitonin in clinical evaluation of prognosis of severe pulmonary infection and understand the infection condition timely to instruct the use of antibacterial drugs. METHODS The clinical data of 120 patients with pulmonary infection admitted to ICU from Jun. 2010 to Jun. 2013 were retro- spectively analyzed. The infected patients were divided into the survival group and the death group according to their prognosis. The PCT and APACHEⅡ were calculated on the 1st, 5th day of enrollment, and last day before death or transferred treatment. The data were analyzed using the statistical software SPSS 18.0. The value of procalcitonin in clinical evaluation of prognosis of severe pulmonary infection was investigated through comparative analysis of prognosis in the two groups. RESULTS There were no significant differences in age and the initial PCT and APACHE Ⅱ scores between the survival group （n= 90） and the death group （n= 30）. But there were signifi- cantly differences in admission time to ICU, PCT and APACHE Ⅱ scores at and after 5 days of admission between the two group （P〈0. 05）. A positive correlation was found between PCT level and severity of disease. When PCT score was high, the infection was more serious; continuous increase of PCT score usually indicated a poor prognosis in patients（r=0. 979 ,P〈0.01）. CONCLUSION The PCT can reflect the severity of severe pulmonary infection in patients in time, and has important clinical value to evaluate prognosis of infected patients.