动态监测PCT、DIC评分及APACHEⅡ评分在脓毒症预后评估中的应用

Application of Dynamic Monitoring of PCT,DIC Score and APACHEⅡ Score in Evaluating the Prognosis of Sepsis

目的探讨脓毒症患者降钙素原(PCT)、出凝血(DIC)评分,结合APACHEⅡ评分动态变化对其预后的评估价值。方法选择130例脓毒症患者,监测其入住ICU后第1、3、7天的PCT、DIC评分的动态变化,并同时记录APACHEⅡ评分的变化。患者根据其28天生存情况分为好转组和死亡组。分析组间PCT、DIC评分及APACHEⅡ评分的变化及与预后的关系。结果死亡组各时间点的上述指标均明显高于好转组,差异有统计学意义(P<0.05)。DIC评分各时间点比较无动态变化,差异无统计学意义(P>0.05)。好转组第1、3天PCT、APACHEⅡ评分比较差异无统计学意义(P>0.05),而第7天PCT、APACHEⅡ评分下降明显,差异有统计学意义(P<0.05)。死亡组各时间点比较差异无统计学意义,持续维持较高水平。结论在脓毒症患者中,动态监测PCT、DIC评分结合APACHEⅡ评分的变化趋势有助于评估预后,持续高水平提示预后不良。

Olbjective To investigate patients with sepsis procalcitonin （PCT）,coagulation score （DIC score） and APACHE Ⅱ mark the dynamic changes of its prognostic value.Methods Totally 130 cases of patients with sepsis were selected.All the patients were measured the PCT,DIC score and APACHE Ⅱ score change at the first,third and seventh days in ICU.According to the 28 days of survival,patients were divided into improved group and death group.We compared the difference of PCT,DIC score and APACHE Ⅱ score and explored the prognostic relationship in all groups.Results The indexes of death group at different time points were significantly higher than those in the improved group,and the difference was statistically significant （P ＜ 0.05）.The DIC score at each time point was not changed,and there was no significant difference （P ＞ 0.05）.The difference of PCT and APACHE Ⅱ score between the first and the third day in the improved group was no significant（P ＞0.05）.The PCT and APACHE Ⅱ score decreased significantly at the seventh day,and the difference was statistically significant （P ＜ 0.05）.The indexes of death group at each time point had no significant difference,continued to maintain a high level.Conclusion In patients with sepsis,the dynamic monitoring of PCT,DIC score and APACHE Ⅱ score were helpful to evaluate the prognosis.Sustained high level indicated a poor prognosis.