血清PCT、CRP水平对脓毒症的诊断及预后评估的价值

Diagnostic and Prognosis-Evaluted Value of Serum Procal Citonin and C-Reactive Protein on Sepsis

目的探讨血清PCT、CRP水平对脓毒症的诊断及预后评估的价值。方法回顾分析2012年7月-2013年5月入住本院EICU的危重患者120例,其中脓毒症患者63例,非脓毒症患者57例作为对照。脓毒症患者根据预后情况分为生存组和死亡组,分析各组的血清PCT和CRP水平。结果脓毒症组血清PCT和CRP水平以及APACHEⅡ评分和SOFA评分均显著大于非脓毒症组（P〈0.05）;血清PCT诊断脓毒症的敏感性、特异性、阳性预测值和阴性预测值均明显大于血清CRP（P〈0.05）;生存组的血清PCT和CRP值在第1、3、5、7天均显著地小于死亡组（P〈0.05）,并有显著的时间效应（P〈0.05）,但在死亡组却无显著的时间效应（P〉0.05）。结论血清PCT和CRP是诊断脓毒症和评估预后的可靠指标,并且血清PCT敏感性和特异性高于血清CRP。

Objective To explore the diagnostic and prognosis-evaluted value of serum procal citonin（ PCT） and Creactive protein（ CRP） on sepsis. Methods A total of 120 patients in our hospital EICU from July 2012 to May 2013,including 63 cases of sepsis（ sepsis group） and 57 cases of cases of non-sepsis（ non-sepsis group） were tested the levels of serum PCT and CRP. Sepsis patients were divided into survival group and death group according the prognosis. Results The levels of serum PCT and CRP,as well as acute physiology and chronic health evaluation Ⅱ（ APACHEⅡ） scores and sepsis related organ failure assessment（ SOFA） scores in the sepsis group were significantly larger than those in the nonsepsis and control groups（ P〈 0. 05）. The sensitivity,specificity,positive predictive value,and negative predictive value for serum PCT in diagnosing sepsis were significantly larger than those for serum CRP（ P〈 0. 05）. The levels of serum PCT and CRP in survival group were less than those in death group on the 1,3,5,and 7 days（ P〈 0. 05）. Moreover,there was significant time effects on level of serum PCT1 and CRP in survival group（ P〈 0. 05）,but not in death group（ P〈 0. 05）.Conclusions The levels of serum PCT and CRP are reliability indexes for in diagnosing sepsis and evaluating prognosis. Moreover the sensitivity and specificity of serum PCT were better those of serum CRP