摘要
目的探讨脓毒症患者血清降钙素原(PCT)水平动态变化的规律及其意义。方法采用前瞻性队列研究入选2012年11月至2013年10月于兰州军区兰州总医院重症监护治疗病房、急诊科病房、呼吸内科重症监护治疗病房住院的所有脓毒症患者,依据脓毒症严重程度分为脓毒症组、严重脓毒症组和脓毒性休克组,于入选后第1、3、5、7日4个时间点分别检测每例患者血清PCT水平,同时对其进行急性生理与慢性健康状态评分Ⅱ评分。结果总共纳入235例合格研究对象,28 d内的病死率为21.3%(50/235),脓毒症组和脓毒性休克组第1、3、5、7日PCT水平呈下降趋势,严重脓毒症组PCT水平呈先升高后下降的趋势(P<0.01)。死亡组和存活组PCT水平比较差异有统计学意义,死亡组PCT水平高于存活组(P<0.01);两组入院不同时点间PCT水平比较差异有统计学意义,均呈下降趋势(P<0.01)。结论血清PCT水平下降程度小者病死率高,血清PCT作为脓毒症一项有用的检测指标可指导其病情和预后。
Objective To investigate the rule and significance of dynamic variation of serum procalcitonin（ PCT） level in sepsis patients. Methods This was a prospective cohort study. In this study,we selected all eligible patients from ICU,the emergency room and ICU of respiration medicine in Lanzhou General Hospital from Nov. 2012 to Oct. 2013. Serum PCT levels were analyzed from blood samples of those at baseline on admission and at 1st,3rd,5th,7th afterwards,and the acute physiology and chronic health evaluation Ⅱ（ APACHEⅡ） scores were given. Results Altogether 235 eligible patients were selected. The 28-day mortality was 21. 3%（ 50 /235）,the PCT level of the sepsis group and sepsis shock group showed down trend on the 1st,3rd,5th,and 7th day,while in the severe sepsis group it showed first up then down trend（ P 0. 01）. The PCT level of the death group was statistically significantly higher than the survival group（ P 0. 01）; PCT levels of the two groups at different times points were statistically significantly different,while they were both in a down trend（ P 0. 01）. Conclusion The mortality of the group with smaller PCT decrease is higher. Serum PCT can be used as a useful biomarker to indicate the condition of sepsis and the prognosis.
出处
《医学综述》
2015年第2期308-309,314,共3页
Medical Recapitulate
基金
全军十二五后勤科研面上项目(CWS11J230)
