降钙素原与血小板指标影响急诊脓毒症患者预后

Procalcitonin and blood platelet influence the prognosis of emergency sepsis

目的：探讨脓毒症患者降钙素原及血小板指标变化与病死率等相关性,以期指导临床。方法：选择符合入选条件的脓毒症患者78例,入院即刻查血常规、降钙素原及行血培养,入院第4天复查血常规,血培养结果依据细菌染色分为革兰氏染色阴性（G-）和革兰氏染色阳性（G＋）。①依据降钙素原值分组,A组（〉100μg/L）、B组（10~100μg/L）、C组（1.5~10μg/L）、D组（〈1.5μg/L）,比较各组入院30d病死率、血培养细菌G-和G＋菌例数及病因差异;②依据入院时血小板数值将所有脓毒症患者分为血小板减少1组与血小板正常1组,后组依据入院第4天血小板数值分为血小板减少2组与血小板正常2组,比较组间病死率等。结果：所有脓毒症患者,随降钙素原增加,病死率增加,同时G-细菌所占比例增加,肺部感染增多。脓毒症患者入院3d后血小板减少,增加病死率。结论：脓毒症患者入院降钙素原数值在一定程度上可指导临床选择抗菌素及指导预后。脓毒症患者入院3d后血小板减少增加病死率。

Objective：To investigate how procalcitonin and blood platelet influence the prognosis of emergency sepsis. Method..78 sepsis patients were selected and experienced blood routine, procalcitonin and blood culture on the first day after being admitted. The patients were given blood routing test again on the fourth day after being admitted. Bacteria with G- and G＋ were divided by blood culture. ①All sepsis patients were divided into four groups：A group（≥100 ng/mL） ,B group（10-100 ng/mL） ,C group（1.5-10 ng/mL） ,and D group（〈1. 5 ng/ mL）. The mortality of 30 days after admission, blood culture and cause of diseases were compared separately; ②All patients were divided into the thrombocytopenia group1 and the non-thrombocytopenia group1 according to platelet number on the first admitting day. The non-thrombocytopenia groupl were further divided into the thrombocytopenia group 2 and the non-thromboeytopenia group2. Result： The mortality on 30 days after admission increased with procalcitonin increasing,and the pulmonary infection increased. The mortality on 30 days after admission increased if thrombocytopenia appeared 3 days after admission. Conclusion ： The level of procaleitonin and thromboey- topenia at 3 days after admission have relationship with prognosis,which can help us during clinical work.