血清降钙素原水平对ICU严重脓毒症患者早期诊断和病情评估的临床意义

Significance of Serum Procalcitonin Level in the Early Diagnosis and Disease Assessment of ICU Patients with Severe Sepsis

目的分析血清降钙素原对ICU严重脓毒症患者早期诊断及病情评估的临床价值。方法随机抽取我院ICU自2011年12月至2013年12月收治120例脓毒症患者作为研究对象,按照病情严重程度,将其分为A组(脓毒症组,n=46)与B组(严重脓毒症组,n=74),于入院24 h内分别检测两组的血清降钙素原、白细胞计数及C反应蛋白水平,并采取APACHEⅡ评分量表评价脓毒症患者器官功能衰竭程度,分析不同指标与严重脓毒症患者早期诊断与病情评估的相关性。结果严重脓毒症患者血清PCT水平、白细胞计数、CRP、APACHEⅡ评分均显著高于A组患者(P<0.05)。74例严重脓毒症患者,1月后死亡34例,存活40例;死亡组患者的血清PCT水平、CRP、APACHEⅡ评分均明显高于存活组(P<0.05)。结论在严重脓毒症患者的早期诊断中,可将血清PCT作为评估患者病情进展的相关性指标,同时辅助APACHEⅡ量表评估,可提高严重脓毒症的检出率,为患者的早期治疗提供指导。

Objective To analyze the clinical value of serum procalcitonin（PCT） level in the early diagnosis and disease assessment of ICU patients with severe sepsis. Methods 120 cases of ICU patients with sepsis were selected and divided into group A（sepsis group, n =46） and group B（severe sepsis group, n = 74）. The serum procalcitonin, blood cell count and C-reactive protein level were detected within24 h after admission. APACHE Ⅱ rating scale was used to evaluate the degree of organ failure, and the correlations between different indicators and early diagnosis and assessment were analyzed. Results The PCT level, blood cell count, CRP and APACHEⅡ score of group B were significantly higher than those of group A（P〈0.05）. Among 74 cases of severe sepsis, there were 34 cases of death and 40 cases of survival after 1 month; The PCT level, blood cell count and CRP of death group were significantly higher than those of survival group（P〈0.05）.Conclusions In the early diagnosis of severe sepsis, serum PCT can be used as assessment index of disease progression; Combined with APACHEⅡ scale, we can improve the detection rate of severe sepsis, and provide guidance for the early treatment.