降钙素原联合APACHE Ⅱ评分对脓毒症病情及预后判断的指导价值

The Guiding Value of Procalcitonin and APACHEⅡ Score for Prognosis of Sepsis

目的探讨血清降钙素原(PCT)检测联合APACHE Ⅱ评分对脓毒症病情及预后的价值。方法对长沙市第四医院重症医学科68例脓毒症患者按疾病的严重程度分为脓毒症组、严重脓毒症组、脓毒性休克组,分别检测各组血清PCT,并同时进行APACHE Ⅱ评分,对PCT与APACHE Ⅱ进行相关性分析。然后再根据患者转归不同分为生存组和死亡组,评价PCT、APACHE Ⅱ评分对脓毒症预后的判断的指导价值。结果脓毒症组PCT低于严重脓毒症组,严重脓毒症组PCT低于脓毒性休克组,其差异均具有统计学意义(P<0.05),死亡组PCT及APACHE Ⅱ评分明显高于生存组,差异具有统计学意义(P<0.05)。结论脓毒症患者PCT水平与APACHE Ⅱ评分具有相关性;检测PCT水平联合APACHE Ⅱ评分对脓毒症病情及预后判断具有指导价值。

Objective To investigate the value of serum procalcitonin （PCT） detection combined with APACHE Ⅱ score for the prognosis of patients with sepsis. Methods A total of 68 patients with sepsis in the ICU（Intensive Care Unit）of the Fourth Hospital in Changsha were divided into three groups according to clinical severity： early sepsis group, severe sepsis group and septic shock group. For septic patients in each group, serum PCT values were detected, APACHEⅡ scores were calculated simultaneously, and the correlations between PCT and APACHEⅡ were analyzed. Then patients were divided into survival group and death group according to their different outcomes, to evaluate the guiding value of PCT and APACHE Ⅱ score for prognosis of sepsis. Results The PCT values in early sepsis group were obviously below that in severe group, and PCT values in severe group were obviously below that in septic shock group, the differences were statistically significant（P〈0.05）, moreover, the PCT and APACHEⅡ scores of death group were significantly higher than that of survival group, the difference was statistically significant （P 〈0.05） Conclusion The PCT levels of patients with sepsis and their APACHEⅡ scores are correlated; It is valuable to detect the PCT levels combined with APACHEⅡ scores for the prognosis of patients with sepsis.